Squeaky Wheels, The Health Care Debate, and Student Complaints About Grades

The academic year at Stanford has started and, although my main teaching isn't until next quarter, I am starting to review my courses and think about what changes I am going to make this year.  After thinking about last year, and some of the complaints I had about grades, I am thinking that I need to spell-out my policy more strongly and clearly than before: If you complain about your grade on an assignment, I regrade the whole assignment and your grade can go up and down.  This kind of policy is necessary in my classes as -- especially for the engineering students I teach -- doing well requires strong writing and creative skills, and is more objective than the problem sets and other objective tests that students often get in other classes.  My final exam question, for example, is "Design the ideal organization. Use course concepts to defend your answers."  I have learned over the years that there seems to be little relationship between how much students complain and the quality of their work.  I sometimes think it is a personality characteristic.  More likely, however, there are a subset of students who have learned that the more they complain about grades, the better grades they get. 

Although I don't like student complaints,some compelling research shows there are considerable rewards for people who complain. This brings us to the health care debate because there is good reason to believe that whatever system  we end-up in the U.S., that we ought to take the squeaky wheel problem into account -- both to protect patients and insurance companies.   There was fascinating 2004 study published in the Annals of Emergency Medicine by Carole Roan Gresenz and David M. Studdert on the outcomes of approximately 3500 disputes filed by patients over insurance payments they received for emergency room visits (here is the abstract).   These data were provided by two of the largest Health Maintenance Organizations in the United States.  The researchers found patients who filed formal complaints through the appeals process won more than 90% of the time -- and the average size of the bill disputed was $1,107, so not exactly chicken feed.  The other lesson from this research is that people who did not appeal never got a penny -- so squeaking definitely paid-off. The policy questions are complex and I lack the knowledge to untangle them here. Many people do not appeal, so the lesson might be that it is cheaper from HMOs and other health insurance operations to underpay consistently and just cave in quickly when people do complain.  The result may be that a lot of people are unwittingly getting worse coverage than they deserve because they don't have the time, motivation, or information about the odds of success. And a related result might be that insurance providers have a system (not entirely of their own design... they are constrained by laws and rules) that is producing a massive number of complaints.

The broader lesson, to go back my grading and the squeaky wheel problem, is that there are probably too many incentives out there for all of us to complain... and if you are running organization or system that you believe uses fair standards to judge people's merit, performance, or whatever -- but people seem to be complaining constantly anyway -- take a good look at how you respond to complaints. Do the squeaky wheels get the grease, whether they deserve it or not?

Comments

[Oliver]

The "4-Hour Work Week" book by Tim Ferriss has a section where he brags about being a "squeaky wheel". Basically his story is that whenever he gets a low grade he goes into the office and complains until the TA/Professors gets tired. This way he "trains" them to give him a hirer grade as to prevent future encounters.

I thought that was rather underhanded and rewards bad behavior...but if it works, people will continually to do that. My question though is how this applies from a culturally perspective. My impression is that whining in some culture is frowned upon...and sometimes leads to worse outcomes for the "whiner".

[Rodney Johnson]

Bob, where is the fine line between whining/complaining and feedback. I'm certain that many organizations view what could be considered feedback as whining, and possibly vice-versa. If this is the case, this is a problem.

Isn't whining simply another form or feedback? If the original feedback not achieve results, isn't the next logical step - whining?

And if whining produces results, doesn't this simply suggest that a problem might exist? Otherwise, it would have been defended.

When feedback is viewed as whining, isn't this a silent problem that will impact business performance?

[Ed Reid]

"If you don't ask, you won't get it."

Many people live by that. Others are offended by the perceived unfairness of those asking getting what they want. Is it unfair? That may depend on culture, personal beliefs, etc.

Perhaps there should be more Art and Science of Negotiations classes - for both professors and students.

Also, I'd like to see the results of a survey of "the ideal organization" as well.

[Jaana Valimaki]

Great topic!
I just recently have been thinking about this "whining" thing, especially in the classroom. In one of my MBA classes a student complained (he did a very silly and clear mistake in an assignment and missed points) that it was the fault of a professor that he didn't clearly enough state what needed to be done. To me the assignment was very straightforward and clear, and the student in my mind, was the only person to be blamed. But no, the professor gave him more time to revise the assignment! This is very wrong and unfair in my opinion. What my underlying point is that classrooms in the U.S need more discipline, and respect towards the professors and fellow students. Professors sometimes let the students walk all over them. There are good complaints too, but they need to be backed up and respectfully expressed.
Thanks!

[Zac Rogers]

Dr. Sutton,
This is a great observation. In almost every organization I have been a part of I have found that the loud people have gotten more attention. It makes sense that this would be the case. Certainly in my own life I pay more attention to the louder things. However, I find that in US culture "whining" and "complaining" are looked at as undesirable behaviors. Why do you suppose this is the case if they are in fact effective?

[Derek Panoply]

I agree that there are many professors out there who reward obnoxious students in the manner you describe. I'd suggest however that there is also the other side to the problem.

I recently finished an MBA program and found in one case that a terrible professor (inconsistent teaching, hostile responses to questions, lack of command of his material, fixation on personal grievances irrelevant to the course) used this same policy to discourage questions about grading.

Any questions at all about why largely unexplained and often glaringly wrong grades were assigned was taken as a request for regrading. Then the professor took obvious delight in finding at least three other places to lower the mark for every undeniable error in marking that the student asked about. It goes without saying that most of the students in the class ended up disgusted and concentrated on minimizing all contact with the professor, in an effort to survive and get out. Education suffered.

While reflexively complaining students are a trend, I wanted to point out that vindictive professors can also be. Hopefully both in a minority.

[Alicia-Ann Caesar]

Thanks for highlighting this topic. I have always found the "squeaky wheel," approach - annoying, I thought to myself what good is complaining, but after returning to the class room as a student and witnesing the benefits "squeaky wheels" get and seeing it work recently at my job I am rethinking just what "complaining," brings to the table.

Last week I was horrified to witness a professor at my university cave in to some students in my class, who complained that he had not been specific enough in his assignment. At the time I thought to myself- they have to be joking and stop complaining your grown adults- but then the umimaginable happened as my professor back tracked and changed their grades. Now I see why the students complained - they knew they were wrong (I hope), but saw that my professor was not sure of himself and his system- so they went for it- they tried and succeeded in manipulating the system...it makes a non-complainer rethink my approach to everyday problems.

Also at work I have recently noticed that the people who complain the most about having "so so much work to do," my boss- she tends to then not give them more work...hmmm

I am starting to see that there is some benefit to speaking up and plan to workon being more vocal at work in school, though I think for me it will have to be "real" or serious problems for me to try my hat at being squeaky.

[Thomas]

This is a great point! The hardest part of being a manager must be not to reward people for making unreasonable demands and making them often.

BTW, Have you ever written a survey of some of the best ideas your students have for "the ideal organization"?

[Kevin Rutkowski]

Two comments:
1) I had a friend who worked as a software tester at UHG. He said that there was a lot of pressure to test that the rejection of claims didn't miss any valid rejection but no pressure to ensuring that the valid claims were always paid correctly. This is the same company that once lost a lawsuit for purposely rejecting most valid large claims because they knew that most people don't appeal, especially when they have the pressures of severe medical problems to deal with.

2) In my Art and Science of Negotiations class, we learned that many times you get what you want simply by asking. In addition, recent studies show that the gender gap in pay is partially due to the fact that women ask for higher pay less often then men.