Heisenberg and Quality

This is from Wikipedia:

In quantum mechanics, the uncertainty principle is any of a variety of mathematical inequalities asserting a fundamental lower bound on the precision with which certain pairs of physical properties of a particle, such as position x and momentum p, can be simultaneously known. The more precisely the position of some particle is determined, the less precisely its momentum can be known, and vice versa.

Dr. Werner Heisenberg came up with this in 1927.  I will now change this to relate it to healthcare and quality indicators.

In healthcare, the uncertainty principle is the conflict that occurs when you believe measuring a few quality indicators of a patient will predict the rest of the care given to patient.  Unfortunately, the more precisely you care for some aspects of a  patient’s health the less precisely you care for other parts, and vice versa.

This is still a work in progress.  Please feel free to rework in the comment section so that I can get this right.

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] 

  4 comments for “Heisenberg and Quality

  1. big picture doc
    July 4, 2012 at 6:52 pm

    Very good analogy. And when you have big pharma-sponsored medical societies determining what is going to be measured, you can forget about good patient care.

  2. Pat
    June 30, 2012 at 6:39 pm

    THIS is why I love this site!

    • July 4, 2012 at 12:59 pm

      This is PRECISELY what’s happening in education. They look for the simplest things to measure (test scores) and then base theory on that. The invalidity/unreliability of most standardized tests is ignored, because it gives us NUMBERS-Praise the Lord! And how do you evaluate teachers? Test scores, of course. And unproven gimmicks like charter schools and “value-added” curriculum become the fads of the day, because they produce fraudulent numbers.

  3. June 30, 2012 at 11:19 am

    Seems like a very good example of why taking symptoms out of context often leaves the patient sicker — or dead.

    I’m thinking particularly of the recipe card medicine such as the pneumonia protocols adhered to so strictly by those looking over the shoulders of physicians and telling them how they may or may not treat a patient.

    Or the medicare review process, where the reviewer denies the appropriateness of acute hospital admissions rather than observation admissions. My physician husband had a patient present to the ER with Addison’s, DM, hypothyroidism, lupus anticoagulant, DVT, PE, and MRSA. He received a report that according to Milliman Care Guidelines, “it appears the observation/lesser level of care versus the acute inpatient billing would be the most appropriate.” Neither Milliman nor this reviewer knows, or more importantly, cares.

    The newfound emphasis on patient-centered care does not address this recipe dance that physicians have to constantly skirt in order to provide the kind of care they know their patients need and deserve. Indeed, patient-centered care can’t become a reality until physicians are given back their ability to make medical decisions in cooperation with their patients.

    Yes, bring on the Heisenberg uncertainly principle. But I’m not sure those trained to take phrases out of context to justify the unjustifiable have the ability to understand quantum anything.

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