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.
As Hillary Clinton’s motorcade sped toward the Chicago hotel hosting the American Medical Association’s annual meeting in June 1993, the clergyman giving the invocation made a jarring request of God: that the audience not boo the speaker.
