The Quality of Medical Care by Ted Bacharach MD (retired)

In industry “quality” has been assessed by how individuals have fared with any particular service or item. Questionnaires regarding the service or item have been accepted as valid measures of the quality and reliability of the product or the service rendered. The application of the “Questionnaire” in another sphere may result in conclusions that do not seem entirely satisfactory. I believe this is the case when officials in the government evaluate questionnaires related to the quality of medical care patients or their relative have received. In the case of the patient being questioned there are several factors that should be considered. The patient who is dead can no longer complain. The patient who has been discharged is thankful he or she escaped alive and has no means of determining whether the level of care he or she received was appropriate or adequate or that the surgery he or she underwent was really indicated. In the case of the questioned relative, there is a large quantity of guilt or emotional distress so that the reliability or accuracy of their evaluation of the patient’s care seems relatively poor. The emotional entanglement of patients or their relatives in applied medical care is so complex that the questionnaire as a valid evaluation tool seems completely invalid or in most cases of little value. As physicians we should accept the responsibility of evaluating the care patients receive as well as the quality other physicians have provided them. Administrators may be able to make financial decisions but we should not let them evaluate everything on a financial basis.