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Posts Tagged ‘ quality improvement ’

Ways to Improve Family Physician Quality – Measure Other Aspects of Primary Care Capacity Associated With Better Outcomes

4
July 9, 2017

In our recent paper criticizing how industrial Quality Improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward. This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or...
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Ways to Improve Family Physician Quality – Measure When Physicians Do Not Order Tests or Treatments

0
June 29, 2017

In our recent paper criticizing how industrial Quality Improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward. This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or...
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Ways to Improve Family Medicine Quality – Target Ranges without Absolute Goals

1
June 18, 2017

In our recent paper criticizing how industrial Quality Improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward. This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or...
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Ways to Improve Family Medicine Quality – Shared Decision Making

1
June 7, 2017

In our recent paper criticizing how industrial Quality Improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward. This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or...
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Industrial QI Does Not Work in Primary Care

1
March 15, 2017

Traditional industrial QI does not work in primary care. A recent publication brilliantly makes this case on both theoretical and practical levels ;-). On a theoretical level, primary care is best thought of as a complex adaptive system, not a simple linear mechanical system. Think of complex adaptive systems as kind...
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Loss of Professional Joy

0
April 10, 2013

Larry Bauer, who is a leader in family medicine education in the northeast U.S., sent out a link to a piece written by teacher who complained about the over-emphasis on standardized tests in secondary education. He felt so bad about it, he quit teaching.  Here is the link: http://www.washingtonpost.com/blogs/answer-sheet/wp/2013/04/06/teachers-resignation-letter-my-profession-no-longer-exists/ Larry asked...
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Cathing the 27-Year-Old

3
July 16, 2012

I’m back from the big annual TAFP meeting, and once again my colleagues tell me stories of crazy practices in the private sector. Here is one from a doctor in Plano. A 27-year-old male patient of his went to the ER with chest pain. The EKG showed early repolarization and the...
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Electronic Medical Records – The 3% Solution with Few Improved Outcomes

3
March 25, 2012

The evidence continues to build on how little electronic medical records (EMRs) contribute to healthcare. A Cochrane review of on-screen computer reminders found that physicians’ practices (process measures, medication ordering, vaccinations, and test ordering) improved by 4% and patients’ surrogate health measures (blood pressure or cholesterol levels) improved by 3%. Another...
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Primary Care Physicians Know U.S. Healthcare is Too Aggressive

6
December 11, 2011

A study in Archives of Internal Medicine surveyed a national sample of internists and family physicians about cost issues in medicine. Over 600 responded. 42% felt that most patients in their own practices receive too much care, only 6% said too little. When asked why some patients received too much care,...
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What is the Cost of Quality?

1
October 16, 2011

I’m not the only one who has questioned the real impact of the quality movement in healthcare. Robert Brook, MD, ScD of RAND Health has written about similar concerns. In an article in JAMA from last year, he states “ore than 40 years later it is unclear what the quality movement...
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