Several contributors have pointed out that it is not only the limited time clinicians have with patients, but also the burden of documentation, poorly designed EHRs, and quality measures of dubious relevance that threaten our ability to create meaningful relationships with our patients. Quality measures are growing in number with the rise of pay-for-performance payment models. Is it desirable to have standardized quality measures in primary care? Have you been involved in the creation of quality measures? What quality measures actually improve outcomes for patients? If "what gets measured gets done," would it be desirable to create a quality measure around rapport, trust, or other intangible qualities of the clinician-patient relationship?
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