What this physician thinks is wrong with quality benchmarking

Many physicians are now evaluated based on the health outcomes of their patients, or at least the numerical data that is closest to approximating the health outcomes of their patients. This may translate to surgical complications, diabetes management or vaccination or medication compliance.

For Abigail Zuger, MD, an internist and infectious disease specialist, her benchmark for continuous quality improvement is the HIV viral load. As Dr. Zuger confessed in a recent blog for The New York Times, her grades show she is a "B" student, which for anyone who has the drive to get through medical school is a less-than-satisfactory grade.

Dr. Zuger contributes her failures to a patient whose viral load has dropped from several million to 11,000, despite his distrust of the medical system. She contributes it to another patient who stopped receiving his medications due to issues with his prescription insurance. After missing months of treatment, his viral load was 100,000. He went back on medication and earned Dr. Zuger a failing grade.

However, she writes, those patients are successes in her book.

Like anyone with a less-than-satisfactory report card, Dr. Zuger has a host of excuses, or reasons and narratives for her results. She writes, "You could say it's all so much embroidery. Or you could say that the numbers don't tell the whole story."

Read the full story here.


More articles on integration and physician issues:

Operating in the public eye: Life after the Surgeon Scorecard
Don't call this physician a saint
Boston Bruins owner gives $30M to University of Buffalo's med school

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