Malmeasurement is my word for when organizations use the wrong measures. I’ve written about it before, for instance, here.
The crux of the idea is that by using the wrong measures, organizations automatically get off track because the results are meaningless.
Last week I was talking to a doctor, an internist. She said that her practice, like most around the country, have stopped doing rounds at hospitals. They are kept abreast of their patience progress by hospitals, but have separate realms.
I was horrified by this. Your internist is your regular doctor, the one who actually knows you as a healthy person, and may have years of experience treating you. And they are not primarily involved in your care when you are hospitalized.
“Does it work?” I asked her.
“It works great,” she said, “We all have access to the same information and the specialists do what they do best.”
And then she continued.
“Of course, the patients hate it.”
Ah, now we’ve moved from malmeasurement to matterness (and, yes, I do like making up words!)
The reason for the change in who cares for patients in hospitals is explained in a blog post by a doctor. He writes, “…primary care physicals can maintain a busy outpatient practice without the burden of having to round on patients while they are admitted.”
We patients are seen as a “burden.” Hmm, funny way to create a health care system. In a revolving door health care industry, I imagine that there are people who ambivalent about seeing an internist with whom they may not feel any connection.
But for other people, like me, who take a great deal of care in choosing their physicians, and want desperately to think that they have built a relationship with someone who has seen them in a paper gown year after year, the idea that any doctor will do just won’t do.
We patients matter. Doctors and hospitals that want to pretend that streamlining and efficiency are the best measures to use for health care are simply wrong. The first and primary measure that should be used is: do patients feel cared for in our system?