The Price We Pay: What Broke American Health Care--and How to Fix It

by Marty Makary

I’ve examined hundreds of quality metrics over the years and developed my own. I’ve come to believe many of them need context to be meaningful. The metrics must zero in on what it means for a patient’s quality of life and potential disability. The criteria should focus on significant harm or waste by extreme outliers rather than small variations in practice. The metric also must be measurable and designed so it can’t be tainted by bias or gaming. And finally, a sound metric should be highly actionable for the physician. Metrics such as mortality, while easy to collect, are hard to make actionable. We need more measures that provide direct insight into what the individual physicians can do right now to modify the way they practice.

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