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I made a comment regarding the need to recognize the differences between both the processes and the reasonable expected outcomes with respect to the preparation of:
1. Working trade documents - such as the medical record.
2. Materials for publication, whether in journals or books.
The comment is here: http://forum.mtstars.com/378004.html
I'd like to expand on what I said by first making two observations that I believe are highly relevant to this issue:
First, the human being is hard-wired to strongly prefer that which is "familiar" to that which is "different". Without belaboring the issue, innumerable studies have shown, for instance, that we tend to identify with people who are similar to ourselves. The reason, of course, is that de facto such people are "familiar" to us. The phenomenon is found in many other areas as well - even physiological studies showing differences in metabolic rates when subjects are given tasks to perform with visual images of "familiar" versus "unfamiliar" scenes.
Similarity is but a stand-in for familiarity, and conformity is but a continuum scale for similarity.
Absolute conformity ----->relative similarity -----> Nonconformity
POINT: People who have power over such matters have great difficulty resisting the temptation to require greater and greater levels of conformity, because "differences" arouse anxiety in the primitive brain. There are many people who find any deviation whatsoever to be quite "jarring" to their sensibilities, and these people unfortunately often wind up on the committees that create specifications of one kind or another - such as "style guides". The reason they do so is because it is in their nature to gravitate to positions where they have a degree of power over "nonconformity" - the power to narrow gradations of "difference" to zero (they hope).
But, for a given situation, there are differences that are important, and those that are not. It is, perhaps, one measure of mental health and maturity to be able to differentiate between them.
Which comes to my second point. There are differences and there are DISTINCTIONS without any (real) difference, by which I mean a difference that has a measurable practical impact on any other outcome.
An example from the Web might help illustrate this point. Colors on the Web are often represented by numeric values for red, green and blue (or RGB). A particular color, for instance, might have the values of 157 for red, 16 for green and 235 for blue. Let us say that a "different" color has the values 158-16-235.
But, is there really a difference between the colors, or is this a distinction WITHOUT a difference? Here, the purposes for which the color is being used must be considered. If we are representing this color to be viewed by a human being on a computer screen, the human eye is utterly unable to distinguish between these two RGB specifications. For our purpose, then, we do not have a difference, but a mere distinction without any (real) difference. On the other hand, if we were doing commercial design work of certain kinds, the difference might not be a mere distinction.
The drive for conformity carries with it all manner of costs, both direct and indirect, and the greater the degree of conformity demanded, the more rapidly those costs mount up.
And this is why we have something that is referred to as "tolerances" when we design things. If you required a machine shop to manufacture a case for your product, you COULD specify dimensional tolerances down to any decimal point you wished - if you want to PAY for it. But be aware that both more expensive machinery and a higher level of machinist skills will be required. These are direct costs.
And these direct costs to manufacture your case would only be the start of what you'd pay. There would be a higher number of rejects, for instance, and that in turn would increase your cost of both materials and labor. Reworks would raise your labor costs. It would be more costly to perform quality control tests on your gear, and hence those costs would rise. There are other indirect costs that could be impacted as well. Every one of these costs will be reflected in the price you pay that machine shop for each and every case they deliver.
Now, imagine the shop floor with piles of rejects waiting for the scrap metal dealer. Other piles are awaiting rework. The pile of "accepted" cases grows slowly - and at a cost of $25.60 per case rather than $2.80 if they were built to reasonable tolerances.
And now suppose that all of this was utterly unnecessary because cases built to a much less stringent set of specifications would have worked perfectly well, and the cases built to your extreme tolerances are not DISCERNIBLY any better, or more desirable, in any PRACTICAL way.
"Style guides" - when treated as such - become specifications, and every individual specification carries with it both direct and indirect costs, and the opportunity for "failure". It would seem important, then, to insist that there should be some demonstrable practical value in each and every specification, or else question the reason for its existence. Certainly, we should be unwilling to pay any unnecessary costs associated with specifications that amount to "a distinction without a (real) difference".
"A foolish consistency is the hobgoblin of little minds, adored by little statesmen, philosophers and divines." - Ralph Waldo Emerson
Every "specification" or "requirement" in the production of anything costs money, both to implement and to enforce. As such, the specifications we use should be those that matter, and not those that bring no demonstrable benefit to the product - merely for the sake of "a foolish consistency".