What Are The Best Proxies For Health?

[Guest guest]

Insurers have come up with P4P measurements that are being touted as

proxies for how good of a job we are doing. While there is use in

these measurements I ask if they are really worth measuring? Doing so

detracts us from being physicians and forces us into an accounting role.

Furthermore, are businesses that are paying the premiums to the

insurers really interested in these results or would they be

interested in a different set of metrics?

For starters, I would suggest there is scant evidence that the P4P

questions are proven to be good proxies for health. Asking if a doc

prescribed a beta blocker is less valuable than knowing if the patient

is taking the medicine.

Also, I think that the businesses paying the premiums are not

interested if I ordered the echo. They are interested if I have open

access scheduling.

I think this initial generation of measurements is misguided and off

the mark. While it is clearly important to prescribe the aspirin,

measuring if I am doing so is not very useful because at the end of

the day because it's the patient who determines his/her outcomes more

than I do.

I think we need to move away from doctor centric measurements and

closer towards patient centric measurements. Patient centric

measurements serve dual purposes in that they raise awareness (why do

I need to take the aspirin) and serve to inform us on what we need to

focus on when the patient is in front of us (my patient is not taking

the aspirin).

Lowell