The "experts" are measuring the wrong things

A colleague of mine attended a lecture in Vancouver this past weekend.  Researchers from BC pointed out the stunning health outcomes that arise from PCPs helping their patients work on improving their lifestyle - eat better, exercise more, etc.  The presenters at the conference described all the studies that show how many more lives are saved and how much better the health improvement from this work on the basics when compared to strictly following guidelines.
This colleague also sent me an article describing the profound beneficial effect to health based on how well the physician and patient are connected.(1)
The lead author of the paper, interviewed in the New York Times said:

The doctor-patient relationship is a good thing, but for the last 25 years that relationship has been deteriorating. By focusing on new treatments, new technology and instant access, we have undermined the patient’s ability to have a longstanding relationship with a doctor, to have a doctor who knows him or her as a human being.

If we focus on guidelines and biometrics at the expense of the fundamental attributes of the relationship, we are harming our patients by turning away from powerful interventions and toward weaker ones.  Once the foundation of comprehensive primary care is in place we can build in the rest.

Stop focusing on the wrong metrics - it hurts people.
Start focusing on metrics that reflect the basic work of comprehensive primary care.  Practices with a 'dashboard' of indicators based on these basic elements can improve the care they deliver, and when they do so, the patients get better care.  This is how we get to better outcomes.(2-4)

Gordon Moore

(1) Atlas SJ, Grant  RW, Ferris TG, Chang Y, Barry MJ. Patient–Physician Connectedness and Quality of Primary Care Ann Intern Med. 2009;150:325-335.

(2) Moore LG, Wasson JH.  The Ideal Medical Practice Model: Maximizing Efficiency, Quality, and the Doctor-Patient Relationship.  Family Practice Management September 2007 pp. 20-24

(3) Moore LG, Wasson JH, Johnson DJ, Zettek, J.  The Emergence of Ideal Micro Practices for Patient-centered Collaborative Care.  Journal of Ambulatory Care Management July-Sept 2006 Vol 29, No 3, pp. 215-221

(4) Wasson JH, Anders SG, Moore LG, Ho L, et al.  Clinical Mircosystems, Part 2:  Learning from Micro Practices About Providing Patients the Care they Want and Need.  Joint Commission Journal on Quality and Patient Safety, August 2008, 34(8) pp. 445-452