How do you develop measures for every specialty and subspecialty out there? That's a tough one.
I called Ted Mazer, MD, an otolaryngologist in San Diego and former president of the San Diego County Medical Society. No pun intended, but I got an earful.
"We're all eager to find guidelines that work, outcome measures that help patient care and cost-efficiency. But until they're ready for prime time, they're being used as economic squeezes," he says. "The government, the academies, the health plans are all trying to do it. But until these measures are ready, they should not be put to use as an economic vice on physician practice."
Realistically, in his specialty, he says, one could measure symptoms experienced by patients after ENT surgery, and there are good measures for chronic sinusitis. "Sinusitis is being heavily monitored right now to see if too much surgery is being done."
But Mazer, like several physicians I've spoken with, fears that if doctors are forced to document even more, they will spend less time on patient care.
"That's one of the things that's frustrating the hell out of physicians and causing them to talk about getting out of the practice," he says.
I know one thing for sure. The next few months of federal rule making will be very, very interesting.