The Emperor of Performance has no clothes

Our greatest and worst attribute is seeing and saying that the Emperor has no clothes.  It requires intellectual honesty, a willingness to overcome confirmation bias and perhaps some hubris.  Often we make others uncomfortable with the raw honesty of such proclamations. For years many blogs have decried performance measures.  I have written about this problem for over 10 years.  Currently I serve on ACPs performance measure committee.  In this capacity I have reviewed well over 100 performance measures.  Most performance measures have the potential for harming patient care.  The committee has given a thumb down to many – you can find them here categorized by disease. We have argued about performance measures.  The best positive argument is that one can use them to assess their patient population.  But almost all agree that using them as a payment strategy has dangers and some believe that current strategies are just schemes to decrease physician payment. As I was considering this problem and old Beach Boys song entered my thoughts: Wouldn’t it be Nice?  With apologies to Brian Wilson: Wouldn’t it be nice if we could measure physician quality? Wouldn’t it be nice if patients had one disease that we could treat perfectly? Wouldn’t it be nice if patients believed our recommendations and could afford their treatments? Wouldn’t it be nice if patients had no side effects? Of course we do not live in a perfect world.  So here are some o...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs