DISCLAIMER: This article is NOT REAL. Well, it is real in that it does exist, but it doesn’t contain factual information. It is made up for the purposes of entertainment. And isn’t that the real truth? Probably not.
In honor of the Major League Baseball (MLB) playoffs, the National Committee for Quality Assurance (NCQA) has released the final details of its new quality measure, Lives Saved Above Replacement Doctor (LSD).
“We learned from multiple MLB organizations the value of very convoluted, difficult-to-interpret measures of performance,” said one NCQA official. “It sounded like something that health care needed more of.”
The measure is patterned after the Wins Above Replacement (WAR) statistic, a comprehensive standard that combines all aspects of an MLB player’s value. WAR combines defense, offensive performance, baserunning and/or pitching. WAR is known as a complicated formula created to give a single metric by which to measure a player’s value when compared to a “replacement” player, a player found in the high minor leagues.
LSD similarly estimates a doctor’s total value by measuring how many lives that physician is saving. It is calculated by combining every known quality measure, even those that have shown no bearing on mortality. It excludes anything that makes patient’s lives better, no matter how long they live.
“Doctors and organizations have been complaining about the number of quality metrics and the lack of association with morbidity or mortality with a significant number of them. So instead of improving these measures or getting rid of some, we decided to just combine them all together. We’re also excited that this will include every patient satisfaction score ever received, especially those from patients asking for opioids or antibiotics for viral illnesses because this really tells us how good a physician is. LSD will make it easier for us to tell who the bad doctors are and punish them accordingly.”
The “replacement” level physician is based on interns and advanced practice clinicians.
The NCQA official continues, “We figured that a ‘replacement’ physician is anyone that could step in when a physician sucks at saving lives. Considering that residents, physician assistants and nurse practitioners perform most of the work in medicine now anyway, we believe that they would be an appropriate comparison group that will, in actuality, over-perform most of the physicians.”
Dr. Darl Flake, a Family Physician in rural Iowa, doesn’t like the idea of such a metric. “It just doesn’t make sense. Why would you do this? It has no bearing on how good of care we provide to our patients. It seems to just be another way to restrict payments for physicians. Especially in rural areas, there is no way we will meet such ridiculous and unrealistic outcomes. Can they even explain the metric to us?”
The NCQA reportedly does not appreciate such criticism: “This is just one more example of myopic physicians who don’t see health care the way we do and want more money. This is what has irreparably damaged health care.
“The algorithm that makes up LSD is too complicated for anyone to understand so I won’t even try to explain it. You’ll just have to trust us.”
LSD goes into effect immediately and will impact payment under all major insurers and government payers. NCQA is also strongly encouraging all state medical boards to suspend the license of any physician who does not meet replacement-level standards.