Dr. Emily's Blog

QUALITY IMPROVEMENT (QI): or Is It?* Who says the quality of medicine needs improvement?  According to some, we have the best health care in the world.  What could we possibly do better?  Do you suppose that during the 11 years of medical training I received, the focus was on giving substandard care?  And besides, how do the health care wonks know that what they suggest will improve upon what we are already doing?  Did anyone think to ask those of us providing primary care if we want to do this, or have time to participate in these protracted projects?  No!  However, let’s give the policy makers the benefit of the doubt, and suppose that primary care does need quality improvement.  Common sense would dictate that no one does anything perfectly and that we all can find ways to improve.   The world of QI is not a pretty picture.  First off, it seems as though everyone and their grandmother has some QI program that physicians are expected to implement.   These programs are all

May 2016 editorial PHYSICIAN BURNOUT--updated version Medicine:  “Oh, Physician, How do I stress you?  Let me count the ways:” 11-13 years of intense training under immersion in the “Superman” medical culture Sleep deprivation/interruption Emotional impact of treating serious illness, death, or chronic disability Pressure to work while pregnant/sick/chronically ill Malpractice lawsuits Financial debt EHR/ data entry Federal mandates Insurance hassles Isolation Pay for Performance programs and surveys Repetitive work Pressure to see large volumes of patients Loss of autonomy due to protocols/insurance restrictions/formularies/provider network restrictions etc.. Can you think of more?  I would love to get responses to share. (eurekapedsemily@gmail.com) Physician burnout is characterised by 3 features:  exhaustion not relieved by rest, depersonalization (cynicism), and a sense of worthlessness of one’s work.  Physicians