Skip to main content

Measuring Medical Quality - Let the Games Begin!

There are two ways to raise the quality level.  The old-fashioned way to work and study and practice and seek assistance and practice again and fail and regroup and ultimately objectively increase performance. Here are a few examples of this technique.
  • A basketball player works with a coach and increases his foul shot success rate by 15%.
  • A new medicine increases the cure rate of a disease by 40%.
  • An engineering team invents a cell phone battery that has 5x the storage of current batteries.
There is another way to increase quality ratings that has become quite common.  Lower the standards or game the system.  Here are some examples to illustrate.
  • Lower academic standards in order to increase a high school's can graduation rate.
  • Lower the income threshold of poverty so we can boast that there are fewer impoverished people in our communities.
  • A surgeon's outcome stats rise markedly when he declines to accept very ill patients.
So, if you are trying to improve your own stats, you have 2 pathways available.  Both will increase your rating.  I’ll let readers decide which path is the preferred route.


If we enlarge the hoop, we will increase players' quality.

Indeed, when a hospital or a school or charitable organization is found to be mediocre by those who rate and assess them, often there is push back claiming that the rating methods are 'highly flawed' or have failed to take account of various exceptional circumstances.  In contrast, those who score well never criticize the rating method.  Go figure!

This blog’s raison d’etre is to champion true medical quality. We must be wary before accepting published results, particularly by organizations who rate themselves. Hospitals, extended care facilities, physicians, investigators, medical devices and drugs are all rated.  The public should view these ratings with a tincture of skepticism.  A high quality rating may mask inferior performance. 

Comments

Popular posts from this blog

When Should Doctors Retire?

I am asked with some regularity whether I am aiming to retire in the near term.  Years ago, I never received such inquiries.  Why now?   Might it be because my coiffure and goatee – although finely-manicured – has long entered the gray area?  Could it be because many other even younger physicians have given up their stethoscopes for lives of leisure? (Hopefully, my inquiring patients are not suspecting me of professional performance lapses!) Interestingly, a nurse in my office recently approached me and asked me sotto voce that she heard I was retiring.    “Interesting,” I remarked.   Since I was unaware of this retirement news, I asked her when would be my last day at work.   I have no idea where this erroneous rumor originated from.   I requested that my nurse-friend contact her flawed intel source and set him or her straight.   Retirement might seem tempting to me as I have so many other interests.   Indeed, reading and ...

The VIP Syndrome Threatens Doctors' Health

Over the years, I have treated various medical professionals from physicians to nurses to veterinarians to optometrists and to occasional medical residents in training. Are these folks different from other patients?  Are there specific challenges treating folks who have a deep knowledge of the medical profession?   Are their unique risks to be wary of when the patient is a medical professional? First, it’s still a running joke in the profession that if a medical student develops an ordinary symptom, then he worries that he has a horrible disease.  This is because the student’s experience in the hospital and the required reading are predominantly devoted to serious illnesses.  So, if the student develops some constipation, for example, he may fear that he has a bowel blockage, similar to one of his patients on the ward.. More experienced medical professionals may also bring above average anxiety to the office visit.  Physicians, after all, are members of...

Electronic Medical Records vs Physicians: Not a Fair Fight!

Each work day, I enter the chamber of horrors also known as the electronic medical record (EMR).  I’ve endured several versions of this torture over the years, monstrosities that were designed more to appeal to the needs of billers and coders than physicians. Make sense? I will admit that my current EMR, called Epic, is more physician-friendly than prior competitors, but it remains a formidable adversary.  And it’s not a fair fight.  You might be a great chess player, but odds are that you will not vanquish a computer adversary armed with artificial intelligence. I have a competitive advantage over many other physician contestants in the battle of Man vs Machine.   I can type well and can do so while maintaining eye contact with the patient.   You must think I am a magician or a savant.   While this may be true, the birth of my advanced digital skills started decades ago.   (As an aside, digital competence is essential for gastroenterologists.) Durin...