Out of Control

The Institute of Medicine (IOM) convened a committee to identify core measures for health and health care. In VITAL SIGNS: Core Metrics for Health and Health Care Progress, the committee proposes a streamlined set of 15 standardized mea-sures, with recommendations for their application at every level and across sec-tors. Ultimately, the committee concludes that this streamlined set of measures could provide consistent benchmarks for health progress across the nation and improve system performance in the highest-priority areas. 

Most of the metrics have to do with measures of quality, cost, access and prevention but in more granular detail. However, most are out of the control of doctors, but rather depend on regulators, political leaders and legislators to change the rules, social policies that address the non-healthcare socioeconomic determinant of health disparities and access to opportunities to raise the standard of living.

And yet, many seem to think that piling on responsibilities on the backs of already stressed and overworked doctors is a winning strategy. The BIG FIX will take more than that.

If we are to achieve the goals defined by the IOM, then it will require nothing short of a re-engineering of how sick care is delivered and integrated into other non-sickcare systems. That is a very big challenge to many status quotidiens who will push back. If we want to fix things, then we need to give kids a small breakfast, not big data.

Doctors have most to do with quality of sick care by how they are trained as sick care technicians. The rest is up to other people who have to be willing to pull the oars at the same time in the same direction, most importantly, patients. More importantly, there is no coxswain on the boat. Until there is, our systemic vital signs will continue to suggest pathology.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs