Not only are we responsible for diagnosing and treating the patients who voluntarily present to our offices, we are also held to task for recruiting them for screening and intervention, providing adequate and documented communication, prompt availability and expert coding. Our patients have become consumers, ranking us on the basis of our business as well as our clinical acumen. Numerous bureaucratic organizations have been created to rank our success with preventive compliance in areas such as vaccines and screenings. Patients are asked to critique our skills and weaknesses. The government and third party payers decide what our efforts are worth and penalize us if we overestimate them.
Point systems exist for everything from technology to charting techniques to consultant utilization.
They determine our quality hence our compensation. The conflict between quality service and fiscal solvency is striking. The cost of quality assessment by for-profit companies or governmental organizations must be transferred to both medical practices and patients. My plea is that physicians and patients in individual practice collaboration, scrutinize the quality of the service rendered. Other mutual naivete may be allowing an artificial assessment of true quality in family medicine to dictate what is good and bad in our offices.