With about 400 articles on the subject of "Less is More" overdiagnosis, overtesting, overtreatment, undertreatment, etc. in my Instapaper queue, I figured I should start tackling them again with brief précis or reflective posts so that you can have the benefit of my curating.
I'll probably alternate between older foundational articles and new interesting stuff.
Today: a new article in the British Columbia Medical Journal (BCMJ) by Dr. Martin Dawes, head of Family Practice at UBC, my alma mater.
Dr Dawes captures it well when he writes of the need for a quality measurement system which takes into account appropriate variations in practice, and that such a system must flex and be adjusted as we understand more about the meaning of the data we are collecting.
I was glad to see that Dr Dawes, unlike many others, doesn't put all the weight solely on achieving "targets." It's not that guidelines and clinical measures should be forgotten about, however they are but one part of the larger quality picture and fortunately he spells this out. I worry that governments and health authorities have not yet arrived at this way of thinking.
While I appreciate that things like accessibility are mentioned in the article, I do note the lack of emphasis on (or even mention of) the role of a strong relationship or attachment between doctor and patient in high quality care. Hopefully this is something that decision-makers are well-aware of, and they take it so for granted that they don't explicitly mention it in their articles. :P
This article is a timely piece as physician organizations, health authorities, and governments in Canada begin the discussion about 'what is good care?', 'how can we measure it?', and 'what can we do to make it better?'
Read more in the BCMJ.