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Clinical Crossroads
March 7, 2012

Use of Quality Indicators in Patient Care: A Senior Primary Care Physician Trying to Take Good Care of His Patients

Author Affiliations

Author Affiliations: Dr Landon is Professor of Health Care Policy, Department of Health Care Policy, Harvard Medical School, and Professor of Medicine, Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

JAMA. 2012;307(9):956-964. doi:10.1001/jama.2012.119

Dr A is a senior primary care physician who recently moved from a small private practice to a larger group-model practice. He believes he was able to provide higher-quality and more individualized care for his patients in his small practice. As Dr A has discovered, quality measurement and improvement activities in primary care have evolved from a focus on an individual patient in an examination room to a systems approach that incorporates population management. Although many frustrations remain with physicians' ability to measure and influence the quality of care received by populations of patients, quality measures and monitoring have improved and should continue to improve. However, the perspective of patients and experienced physicians like Dr A also should be incorporated into quality measurement and management systems. Dr A clearly has the welfare of his patients at heart, and his experience and perspective could help improve his organization's systems of care and identify resources to deliver the best care.