What truly counts in medicine isn’t easy to measure

Obamacare has promised to provide all of us with quality medical care that is affordable and accessible. The very name of the law is the Affordable Care Act, which I have maintained will be short on both affordability and quality care.

Most of the country agrees with me. The postponement for a year of the corporate mandate to provide insurance in businesses with at least 50 full time employees was a great relief to these businesses and to Democrats across the country who were shivering from fear that voters would hold them accountable in 2014 when the country witnessed the debacle. Was this solely a policy decision independent of politics?

How will the Obama and insurance company vanguards of bureaucrats ensure quality? They will measure of bunch of silly stuff that is easy to measure but counts for almost nothing. What really counts can’t be easily counted. But, these guys will count what is easy to count and pretend that it matters.

Let’s have readers try their hand at measuring medical quality. Depending upon your responses, you might gain a position with the Department of Health and Human Services.

Which of the following is the best measurement of quality of an obstetrician?

  1. The percentage of Pap smears done on his patient population
  2. The percentage of mammograms done on his patient population
  3. Judgment of when a Caesarean section is appropriate
  4. Patient satisfaction score

Which of the following is the best measurement of quality of a cardiologist?

  1. The doctor puts heart into his work
  2. The doctor and his staff have a good rhythm
  3. The doctor has a good beat
  4. The doctor knows when chest pain is serious

Which of the following is the best measurement of quality of a pediatrician?

  1. All appropriate vaccines are administered
  2. The physician rates very highly on surveys grading compassion and caring
  3. The practice uses a nurse practitioner available for same day appointments
  4. The pediatrician knows when a sick child should be hospitalized

How can the government and insurance companies use your responses in measuring physician quality? Is it possible that what truly counts in medicine isn’t that easy to measure?

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower

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