Will Mandating "Quality Care" Do More Harm Than Good?

In an op-ed in the Wall Street Journal, Jerome Groopman and Pamela Hartzband, staff members of Beth Israel Deaconess Medical Center in Boston and on the faculty of Harvard Medical School, write that "an analysis of [the] drive for better healthcare reveals a fundamental flaw in how quality is defined and metrics applied." They argue that "in too many cases, the quality measures have been hastily adopted, only to be proven wrong and even potentially dangerous to patients." In the past, "quality improvement initiatives focused on patient safety and public-health measures," but now, "government and private insurance regulators" have "turned clinical guidelines for complex diseases into iron-clad rules." Groopman and Hartzband argue that "too often quality metrics coerce doctors into rigid and ill-advised procedures," citing "recent examples" that "show why rigid and punitive rules to broadly standardize care for all patients often break down." They conclude that "we need a national time-out in the rush to mandate what policy makers term quality care to prevent doing more harm than good."