Outcomes Fall Flat

The evidence keeps pouring in that the great “Quality Movement” is failing.  A new study shows that the hospital report cards on quality did NOT improve patient outcomes.   As reported in Health Affairs and explained here in the American Medical News:

Seven years after the federal government started publicly reporting hospitals’ performance on quality measures, evidence suggests that this transparency effort has not improved patient outcomes measurably.

The word on the street is to “temper our expectations”.  How is that for an understatement?  What about the cost for this mess?  I have been screaming from the rafters for years now but no one wants to listen.  Quality measures, though sound nice and should intuitively work, are an absolute failure.  People cannot be treated as numbers.   Nature has a way of proving us wrong every time.  Has no one seen Jurassic Park?  It was written by a physician, you know.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  6 comments for “Outcomes Fall Flat

  1. t mcglone
    March 21, 2012 at 10:36 pm

    Who cares what the public says. They have no concept of healthcare quality or performance.
    Who cares what the Federal Government says ….. only physicians who accept Medicare patients
    or public aid patients, no one else (i.e. Plastic Surgeons ) needs to care.
    The Feds will “encourage you ” to “participate ” in “Meaningful Use” and other programs.
    If you do in the next 3 years you get a “BONUS” from CMS . Wow !
    Beyond 3 yrs if you forgot to care you get a beating with progressively lower reimbursement for seeing CMS patients.
    NO BIG DEAL you say. I’ll quit seeing them, I live in a big city where I don’t need to admit patients to the hospital and can have a concierge cash only practice.
    Just wait.
    The rural docs among us, see 50% medicare, 20% Medicaid, 10% self pay and 20% insured patients.
    The choice is either to move to a health care reform state with full employment or go to taking chickens in payment for appendectomy. ( That is 5 dozen eggs and 6 Fryers by the way).

  2. Bill
    March 21, 2012 at 9:20 pm

    Numbers won’t change outcomes if: the hospitals don’t care about bad press; the patients or referring doctors don’t know about the numbers ; the patients or doctors don’t have a choice, whether due to insurance coverage networks or geographical limitations.

  3. Pat
    March 21, 2012 at 10:42 am

    “Quality” as a replacement for the doctor-patient relationship was inevitable once the government became the actual patient. We work to satisfy, placate, please, and treat government; the human beings who sit on the exam table are the raw material to be processed to accomplish that treatment.

  4. Nancy Lowe
    March 21, 2012 at 10:37 am

    This one, I have to take issue with. First of all, I will point out that you can pretty well find numbers to support whatever hypthesis you want.

    Secondly–is it better not to use evidence-based medicine? To go back to the “it didn’t work, so we’ll do it more often” mentality? It’s like using antibiotics for a cold. If you do, they’ll get better in about a week and a half, if you don’t, they’ll stay sick for 10 days, right?

    Thirdly, are we supposed to ignore medication errors, hospital acquired infections, wrong site surgeries? Maybe it doesn’t improve the outcomes you’re measuring–say length of stay, because the patients who die because of errors have a shorter length of stay than the survivors!

    Sorry–hit my sore spot with that one!

    • Doug Farrago
      March 21, 2012 at 2:16 pm

      We all should work on systems improvement. Quality measures that lead to pay-for-performance is bad for medicine. End of story.

  5. Diane Haugen
    March 21, 2012 at 8:47 am

    Which also speaks to evidenced-based medicine, alas.

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