Metrics Should Be About Physician Outcomes

By NIRAN AL-AGBA, MD
Quality measures began as tools to quantify the healthcare process, using outcomes, patient perceptions, and organizational structures associated with the provision of high-quality health care. Overall, the goals should focus on delivery of care that is effective, safe, efficient, and equitable.  Did you notice a particular word missing?  Yes, I missed the word physician too, because they have been left out of the conversation entirely.
Measuring quality healthcare by a patient lab result is like recording a patient’s temperature by waving the thermometer near their face.  One has little to do with the other except for the slight appearance of connection.  Quality must be measured by physician outcomes and not those of patients.  For instance, our county does not have fluorinated water.  Measuring the percentage of children that have cavities is a patient outcome and not an accurate reflection of medical care provided.  A physician outcome would be calculating the percentage of children who received a prescription for supplemental fluoride during their office visit.
If the intended goal is to reduce unnecessary ER visits, then we must determine the root cause.  Patients with private insurance rarely go to the ER for non-emergencies because they pay a large out-of-pocket cost.

Those on Medicare or Medicaid visit the ER for free.  There is no disincentive to visiting the ER, but there needs to be.  In addition, it makes no sense to penalize me ...

Source: The Health Care Blog - August 8, 2016 Category: Consumer Health News Authors: John Irvine Tags: 2016 Town Hall Source Type: blogs