Cups One-Half Sum As Well As One-Half Empty
Sunday, October 22, 2017
I've been enjoying an telephone commutation over at Twitter amongst Ben Harder, @benharder, principal of wellness analysis at US News in addition to World Report. As he notes, "We issue data, rankings & tools to aid consumers pick out hospitals, doctors, wellness plans & more."
In previous posts, I've expressed major reservations nearly the methodology used yesteryear the magazine. Regular readers powerfulness squall upwards my 2011 column where I said:
US News needs to terminate relying on unsupported in addition to unsupportable reputation, frequently influenced yesteryear anecdote, personal relationships in addition to self-serving populace appearances.
To his credit, Ben has been working on creating a to a greater extent than objective dry reason for his magazine's rankings, but in that place is a even then a major element that relies on doctors' opinions. I want him good inward continuing to brand this whole practice to a greater extent than scientific. (By the way, equally the journal notes, their ranking is non for patients amongst "normal" levels of acuity, but rather is designed to focus on which hospitals best grip the to a greater extent than complex cases. You'd never know that based on how hospitals purpose the rankings inward their advertisements.)
Meanwhile, it has been revealing to focus on other comments inward the Twitterverse in addition to blogosphere that lead keep attacked equally unconscionable recent stories from ProPublica inward which Medicare information on readmissions were used to depict complications rates for America's surgeons. Oddly, I cannot squall upwards whatever of the authors of those diatribes taking on whatever methodological aspects of the US News rankings.
My justice is that the US News rankings lead keep croak such an of import business office of the marketing campaigns of America's hospitals in addition to doctors that whatever such problems autumn away inward the eyes of the profession.
But dorsum to our interchange. Ben notes, amongst optimism:
Thru NSQIP & PQRS, @AMCollSurgeons "has begun the long, arduous procedure of [public] character assessment" of surgeons.
Surgeons' lead house "assessing in addition to improving surgical outcomes...will lead keep some time. It’s complex."
I responded:
NSQIP has existed for years. No indication that it volition survive used for populace reporting. Ever. [Note: More on that here.]
I also noted:
Also c novel AUA information effort: "By urologists. For urologists." Public disclosure non contemplated. U c progress. I c recalcitrance. [Note: Check here for a description of the American Urological Association Quality Registry inititaive.]
His reply:
You may survive right. But the winds of alter are blowing. Growing # of surgeons want #NSQIP to opened upwards up.
I offered:
Winds of change? More similar gentle whispers. As nosotros nation inward politics, count the votes. Inertia's winning.
He answered:
You come across loving cup empty. I come across pelting clouds.
I added:
In short, the medical priesthood prevails: "You are non worthy to justice us."
He answered:
Priests volition survive priests. The congregation is losing its religion.
To which all I tin compass the axe at 1 time produce is respond yesteryear saying, "We shall see." I come across nix on the horizon that suggests that the public's ask to know is equally yet offsetting the profession's want to concur things around the vest. When the numbers adapt them, the profession extolls the results. When the numbers don't adapt them, it's dorsum to: "The information are wrong. My patients are sicker."
In previous posts, I've expressed major reservations nearly the methodology used yesteryear the magazine. Regular readers powerfulness squall upwards my 2011 column where I said:
US News needs to terminate relying on unsupported in addition to unsupportable reputation, frequently influenced yesteryear anecdote, personal relationships in addition to self-serving populace appearances.
To his credit, Ben has been working on creating a to a greater extent than objective dry reason for his magazine's rankings, but in that place is a even then a major element that relies on doctors' opinions. I want him good inward continuing to brand this whole practice to a greater extent than scientific. (By the way, equally the journal notes, their ranking is non for patients amongst "normal" levels of acuity, but rather is designed to focus on which hospitals best grip the to a greater extent than complex cases. You'd never know that based on how hospitals purpose the rankings inward their advertisements.)
Meanwhile, it has been revealing to focus on other comments inward the Twitterverse in addition to blogosphere that lead keep attacked equally unconscionable recent stories from ProPublica inward which Medicare information on readmissions were used to depict complications rates for America's surgeons. Oddly, I cannot squall upwards whatever of the authors of those diatribes taking on whatever methodological aspects of the US News rankings.
My justice is that the US News rankings lead keep croak such an of import business office of the marketing campaigns of America's hospitals in addition to doctors that whatever such problems autumn away inward the eyes of the profession.
But dorsum to our interchange. Ben notes, amongst optimism:
Thru NSQIP & PQRS, @AMCollSurgeons "has begun the long, arduous procedure of [public] character assessment" of surgeons.
Surgeons' lead house "assessing in addition to improving surgical outcomes...will lead keep some time. It’s complex."
I responded:
NSQIP has existed for years. No indication that it volition survive used for populace reporting. Ever. [Note: More on that here.]
Also c novel AUA information effort: "By urologists. For urologists." Public disclosure non contemplated. U c progress. I c recalcitrance. [Note: Check here for a description of the American Urological Association Quality Registry inititaive.]
His reply:
You may survive right. But the winds of alter are blowing. Growing # of surgeons want #NSQIP to opened upwards up.
I offered:
Winds of change? More similar gentle whispers. As nosotros nation inward politics, count the votes. Inertia's winning.
He answered:
You come across loving cup empty. I come across pelting clouds.
I added:
In short, the medical priesthood prevails: "You are non worthy to justice us."
He answered:
Priests volition survive priests. The congregation is losing its religion.
To which all I tin compass the axe at 1 time produce is respond yesteryear saying, "We shall see." I come across nix on the horizon that suggests that the public's ask to know is equally yet offsetting the profession's want to concur things around the vest. When the numbers adapt them, the profession extolls the results. When the numbers don't adapt them, it's dorsum to: "The information are wrong. My patients are sicker."