'Quality' care's perverse consequences

E-mail | Print | Comments () Posted by Elizabeth Cooney April 8, 2009 07:26 AM

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Quality improvement programs in healthcare are only as good as their evidence-based protocols, two Boston doctors write in today's Wall Street Journal. So when those standards are hastily adopted and then proven wrong, patients and physicians can both suffer.

Dr. Jerome Groopman and Dr. Pamela Hartzband of Beth Israel Deaconess Medical Center and Harvard Medical School cite quality measures for blood sugar control in ICU patients on which doctors were judged that were later shown to be dangerous. They also cite the case of Massachusetts pediatrician Dr. Ann T. Nutt, who is fighting the Group Insurance Commission to find out on what basis her performance ranking fell.

"Too often quality metrics coerce doctors into rigid and ill-advised procedures," Groopman and Hartzband write. "Orwell could have written about how the word 'quality' became zealously defined by regulators, and then redefined with each change in consensus guidelines."

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White Coat Notes covers the latest from the health care industry, hospitals, doctors offices, labs, insurers, and the corridors of government. Chelsea Conaboy previously covered health care for The Philadelphia Inquirer. Write her at cconaboy@boston.com. Follow her on Twitter: @cconaboy.

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