When Quality Metrics Ruin the Quality of Care.

Sigh. We knew this would happen… traditional healthcare is getting in the way of itself again.

Quality measurement is a good thing on paper, and not something to be ignored. But implementation of it is, well, complicated. And according to some recent studies, largely unhelpful. When you get down to the nitty gritty, we’re not convinced it does more good than harm, and Dr. Don Berwick, one of the nation’s leading champions in high quality, patient-centered care agrees.

“I have tremendous doubts about the accuracy and utility and overall wisdom of quality metrics at the individual level,” Berwick says. “When it’s a ‘falling off a log’ standard that you know everyone would want the same way then it’s good to know we’re adhering to the standard. The problem comes when we don’t get a chance to modify them to fit individual needs. Can we really be smart enough to write rules that get down to the level of what’s right for each individual patient? So we have to be really careful about these rule-based standards.”

Because it’s true that “doctors are so much more than metrics.”  In fact, a lot of docs feel metric bloat has had a negative impact on quality care. Oh, and it’s not worth the money it takes to implement, either, apparently:

In 2015 the Institute of Medicine issued its own report on the proliferation of quality measures, which found that “the growth in measurement and reporting activities results in considerable expense and requires substantial time commitment, without a matching return on investment.”

It seems that spending too much time measuring the quality is actually ruining the quality. Suddenly this is all too convoluted and you’re thinking – there MUST be a better way. Enter stage right – Direct Care. Where quality is literally the foundation on which DPC practices operate. No need for measurements. Quality just… is. It’s baked into every part of a Direct Care doc’s day – from the smaller number of patients they see, to the longer appointment times, all the way to billing transparency and acute interest in saving their patients money.

Quality shouldn’t be measured in numbers, but rather patient satisfaction. And as more and more patients opt for a truly personal relationship with their physician, Direct Care smiles from ear to ear. Because it has everything we need to show patients what quality’s really like – without any of the controversy.

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