Quality Fusion Cuisine
The article in the print magazine, Family Practice News, was called:
Fusing Quality Measure and Primary Care
I immediately was drawn to it just as a fly would be drawn to a fresh turd. The title wants to romanticize this garbage by making into some avant-garde fusion cuisine. How sexy. The online version is called Integrating behavioral health into primary care which is weird because it has nothing to do with the article. Nice editorial work, FPN.
To be clear, the quality measure fad should be over by now. The evidence doesn’t prove it. In fact, it is against it. But this guy, Theodore Ganiats, MD, seems to ignore all the studies because he is smarter than all of us. But I digress.
The article starts off:
This is the sixth in a series of articles from the National Center for Excellence in Primary Care Research in the Agency for Healthcare Research and Quality.
This has got to be a joke title, right? Read that again. He may as well call it the Ministry of Silly Walks.
But there’s more:
One resource is the National Quality Measures Clearinghouse (NQMC). The NQMC is a database and website for information on specific evidence-based health care quality measures and measure sets, sponsored by AHRQ to promote widespread access to quality measures by the health care community and other interested individuals. For each measure that meets NQMC criteria for inclusion, the site provides structured, standardized summaries that contain information about measures and their development. A dedicated team prepares these summaries using the NQMC Template of Measure Attributes and associated Domain Framework, Glossary Classification Scheme, Naming Convention, and Measure Hierarchy.
It is the Ministry of Silly Walks! (YOU HAVE TO WATCH THE VIDEO ABOVE)
He ends his article with this:
The NQMC mission is to provide an accessible mechanism for obtaining detailed information on quality measures and to further the dissemination, implementation, and use of these measures to inform health care decisions. NQMC is designed for practitioners, health care providers, health plans, integrated delivery systems, purchasers, and others interested in health care quality measurement. Funding for the NQMC is in question, and the future of this resource is not certain.
Yes!! His organization is on the ropes! I get it now. He is begging for help because he is their director and may be out of a job. Well, I for one say, “Don’t let the quality door hit you in the ass on the way out.”
Be well, Dr. Ganiats.
Being vehemently anti-catchphrase, I have to beg you to never use “to be clear” again in any of your writings. When I hear it or read it I wish to ask the user “are you alerting me that you are now done bullshitting me or what”? or some other smart-alecky thing like that.
Please also abstain from using “at the end of the day” and “best practices”. These words “trigger” a part of my brain that is prone to homicidal mania. The latter is particularly odious.
To be clear, this is just how I write. At the end of the day you can just read my stuff or not. I am never done bullshitting. It is part of my best practices.
Huh????
Interesting, there’s an article on KevinMD today requesting us to help save the
AHRQ. For my money I’d rather save the whales.
I would rather read the words “dripping pus fester” than read the word “quality”ever again. Those that have commandeered the word would do well to remember that the words “poor” and “shitty” can proceed their pet word they have ruined for the rest of us.
The few in Technocracy who retain the capacity to think like a human, realize that the entirety of their beliefs rest upon complex axiomatic assumptions that are nonsense. That’s why much of their writing resembles machine-written propaganda.
Every measure of the real world produces a simplification of a complex entity. It is the Reality that exists. The measurement is an artificial description which is only of value depending on its utility. A collection of inaccurate or irrelevant measures is nothing, or rather, an arbitrary collection of stochastic (random) data.
“For each measure that meets NQMC criteria for inclusion, the site provides structured, standardized summaries that contain information about measures and their development.”
The measures are not objective, and the writer tells us so right here. For most measures, a name and a number are paired in their being reported. The mechanism of creating the number is based on complex suppositions, which the writer claims to be reporting. These rules are arbitrary and imposed from the Wise that study such things. Properly, they are collections of paired symbols – a name or noun, and a symbol representing measurement.
“NQMC Template of Measure Attributes and associated Domain Framework, Glossary Classification Scheme, Naming Convention, and Measure Hierarchy.” There are terms to delimit various things in the world of NQMC. This does not mean that they have any relevance to reality. A Taxonomy of Magickal Creatures can have dense complexity, but no reality.
“accessible mechanism for obtaining detailed information on quality measures and to further the dissemination, implementation, and use of these measures to inform health care decisions?” I have a tremendous machine which brings these sorts of things to the bedside. Moreso, my machine brings tacit as well as explicit analysis – something that technocrats fear as much as they misunderstand. It is years of training and study, coupled with years of practice experience.
On Friday, I saw a good ol’ boy who hurt his hip about 2 years ago jumping off the back of a pickup. He came to see me, and something looked not quite right. An x-ray saw nothing, an orthopedic consult returned with calm reassurance. He came back to see me, and something looked not quite right and worse. I obtained a CT, and sent him back to Orthopedics with the comment “suspicious bone erosion of pelvis consistent with metastatic disease. Biopsy.” The surgeon concurred and obliged.
First – were there any mistakes made in his care? The modern lynch mob would fall upon one of us, if not both, and claim some atrocious delinquency. The Technocrats would extol the virtues of CT studies, and algorithms for ordering CT’s.
The diagnostic machine was my mind, looking at this guy and saying something doesn’t fit. And I did, and he was biopsied, and diagnosed with lymphoma of the everywhere, and underwent chemotherapy, and is now disease-free for 2 years. I bring this machine everywhere I go to practice. It was paid for up-front; now it is essentially part of the standard practice.
The Luddites of the 21st century are eager to smash this machine and demean its inventors and operators. Go right ahead, Luddites! See what you get when the smoke clears from the rubble.