Articles of Interest
Article Detail:
Author
Name: Ashish Jha, MD, MPH
Article
Date: March 28, 2014
Source: medpageToday’s KevinMD.com
Site: http://www.kevinmd.com/blog/post-author/ashish-jha
I recently spoke to a
quality measures development organization and it got me thinking — what makes a
good doctor, and how do we measure it?
In thinking about
this, I reflected on how far we have come on quality measurement. A
decade or so ago, many physicians didn’t think the quality of their care could
be measured and any attempt to do so was “bean counting” folly at best or
destructive and dangerous at worse. Yet, in the last decade, we have seen
a sea change. We have developed hundreds of quality measures and
physicians are grumblingly accepting that quality measurement is here to stay.
But the unease with quality measurement has not gone away
and here’s why. If you ask “quality experts” what good care looks like
for a patient with diabetes, they might apply the following criteria:
good hemoglobin A1C control, regular checking of cholesterol, effective LDL
control, smoking cessation counseling, and use of an ACE inhibitor or ARB in
subsets of patients with diabetes. Yet, when I think about great
clinicians that I know — do I ask myself who achieves the best hemoglobin A1C
control? No. Those measures — all evidence-based, all closely tied to better
patient outcomes — don’t really feel like they measure the quality of the
physician.
So where’s the
disconnect? What does make a good doctor?
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