Day of Medical Infamy
So let’s mark down February 16th as a day of medical infamy. This is when the Centers for Medicare & Medicaid Services and America’s Health Insurance Plans announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers. If you do not know what this means then you are not alone. Without proof that quality measures improve care, the CMS and AHIP worked with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.
The collaborative announced core measures in seven areas include:
- Accountable care organizations/patient centered medical homes/primary care
- Cardiology
- Gastroenterology
- HIV and hepatitis C
- Medical oncology
- Obstetrics and gynecology
- Orthopedics.
If you have been reading this blog you know that I have predicted the problems of quality measures from day one. I have pointed out the cost, the lack of proof, the way it takes doctors AWAY from patient care and how it is forcing doctors to quit or retire. So, let’s note these groups who were involved in allowing this “collaboration” to occur:
- American Academy of Family Physicians
- American College of Cardiology
- American Heart Association
- American College of Physicians
- American Gastroenterological Association
- HIV Medicine Association
- Infectious Diseases Society of America
- American Academy of Pediatrics
- American Society of Clinical Oncology
- American Medical Association
Let’s hold their feet to the fire when this thing fails….again. Don’t worry, I will be there to bring this us when they cry crocodile tears and complain in the future that they were unaware. Trust me, I will be there to shove this in their faces.
Dear Thomas G.,
You might be confusing “medicine” and “primary care.” Few surgical specialties on the list, but I count 3 (really one and two halves) that might be primary care organizations. Out of 8. Last time I checked, Cardiology and Gastroenteroly were not considered primary care. And the AMA has been run by specialists for a long, long time…
One more time. I said the groups LEAN toward primary care. There is are no groups on this list that are primarily surgical or procedural. Certainly no groups who realize how bogus is the gatekeeper concept.
Crap. Don’t know whether to be relieved that I’ll be retiring in a few years or scared that as a Medicare patient I’ll be on the receiving end of some of these “quality” measures. At least that’s until the culture makes it a patriotic duty to accept euthanasia at 70.
Logan’s Run 2.0
There is plenty of reason for paranoia, but Thomas Gustavino goes too far. Must not be able to read clearly the list of organizations provided through the anguished tears we all share. “Cardiology,” “Gastroenterology,” “HIV,” and “Clinical Oncology,” are not Primary Care. We should all be so lucky if PCPs really were the gatekeepers this time around. Only a fool would be that optimistic. The same pencil pushing non-clinicians of any stripe that have delivered this monstrosity to us, will be the ones controlling the cash flow to all of us.
First, I said these groups leaned toward primary care. There is little surgery on this list. (Anti procedure bias maybe ?) Second, we tried the “gatekeeper” concept during the late 90s and it failed miserably. Reason: There was no where near the amount of “unnecessary” care that justified having a “gatekeeper”, or for that matter the type of wholesale overhauls of the health care system that are being proposed. Thats why these overhauls are failing.
As I said, what is the definition of insanity?
“Trust me, I will be there to shove this in their faces.” Doug, turn the light out when you’re done. We’ll be missing you.
PS: Having worked for a governmental agency in the past, I can add $6,000-per-year towards my retirement pension by taking a government job. ANY government job in that organization! I’m SERIOUSLY thinking about moving to the Sanitation Services Industry. Things are picking up, and I might get some respect for a change.
Should’ve follow my Dad’s advice to go into civil engineering. I didn’t know what it was but
later found out as long as there are people, there will need to be those how can come up
with creative ways of dealing with their waste. Self fulfilling vocation if you ask me.
Is it my imagination or do the groups that support these measures tend to lean toward primary care? Could it be that, like the failed capitation plans of the late 90’s, primary care envisions themselves to be the “gatekeepers”, collecting the ACO or bundled payment checks and doling it out as they see fit?
What is the definition of insanity?