Posted in Access to healthcare, Economic Issues, Education, Evidence-based Medicine, Health Insurance, Medicaid, Medical Costs, outcomes, outcomes measurement, Patient Safety, Philosophy, Poverty, Prevention, primary care, Protocols, Uncategorized, Unemployment

Bridging the Gap Between Where the Quality Metric Ends and Real Life Begins—A Trusting Relationship |JAMA NETWORK

Jennifer E. DeVoe, MD, DPhil

JAMA Intern Med. 2020;180(2):177-178. doi:10.1001/jamainternmed.2019.5132

My teaching session with the medical student at the end of the day included a discussion about patient care decisions and recommendations that go beyond ticking quality boxes and following the latest guidelines. Initially, I felt as if I was rationalizing my delivery of suboptimal care and began to doubt myself. 

However, the quality reports I receive each month do not capture the complexity of many patients’ lives.4 These reports fail to reflect the individualized and shared decisions made between a patient and her physician who have known each other for 15 years; the proprietary quality score calculation formulas do not adjust for the healing power of relationships.5 Amid the mounting evidence that primary care saves lives,6 our health care system does not (yet) have a population health analytics tool that captures and tracks the progress that she and I have made together in more than a decade. When will we create better systems with capabilities to measure the emergency department visits that were prevented, the stable housing that was obtained, the increased resiliency she has built into her life, her feelings of empowerment to be a better parent, the reduction in her self-destructive behaviors, and the trusting relationship we have built over time?

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2757531?guestAccessKey=15c869b5-37d4-42f4-9feb-12bdc314dbe6&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=etoc&utm_term=020320&appId=scweb

Author:

A primary care physician by training, my passion is researching and writing about the importance restoring patient centered care, supporting independent private physicians, promoting free-market solutions and seeking sustainable fiscal policy in healthcare.

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