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Monday, May 12, 2014

Physician, Heal Thyself...

I was reading a post over on Kevin MD today, and I just had to think "face-desk".  It's a real head knocker of a post.  This physician uses three anecdotes to explain why the current sets of quality measures are flawed and not evidence-based.  And of course, she's right, at least these examples are flawed.

But the real problem isn't the complaint, so much as it is the approach.  If it's not OK to do anecdotal medicine, why is it OK to make anecdotal complaints like this.  If you want everyone to do present high quality evidence, couldn't you at least survey the quality measures you opine are so deeply flawed and indicate whether these are the three outliers in a very small set, or three rather easily found common examples?

I don't doubt the physician reporting the problem is right to complain, but to call all the measures deeply flawed based on three fairly high profile media cases shows a misunderstanding of what it means to do the work.  At the moment, all we have is one expert's opinion.  From my recent studies, that's the lowest quality evidence we could have been presented on the topic. I'd be interested in seeing what else could be wrong here, its a shame she didn't take the obvious step.

   Keith

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