In today’s Annals of Internal Medicine, my colleagues and I describe the saga of the four-hour measure of door-to-antibiotics time for pneumonia – the first truly dangerous measure in the era of public quality reporting. It is an important cautionary tale. As I’ve discussed previously, the biggest surprise of the last decade in the quality field ...

Last week, Medicare added patient satisfaction data to its hospital reporting website. This is progress, but it raises an interesting question: should patient satisfaction scores be case-mix adjusted?The motivation to include patient satisfaction data comes from the Institute of Medicine’s inclusion of “patient-centeredness” as one key component ...

Stuff this week that caught my eye: Does medical tourism harm the natives? Are all those CT scans destroying more than our budgets? Are nocturnalists at risk for more than decubs? Will Medicare need to cut hospital payments to fuel P4P? Answers: yes, yes, probably, and duh.Yesterday, NPR’s All Things Considered described the dark side of medical ...

P4P (pay for performance) is all the rage in healthcare. And why not? In the face of the damning evidence that we ''get it right'' only about half the time, criticizing linking higher payments to better care seems frankly un-American. And there is accumulating evidence that P4P may work. A study earlier this year by my friend Peter Lindenauer ...