What Gets Measured Gets (Micro)managed

Ranji comments that there is no small amount of irony in the fact that efforts to improve the quality of care for patients and quality of life for residents may be damaging residents' fundamental clinical training experiences. No one should call for a return to the days when attending physicians provided only minimal oversight, but the pendulum has swung too far in the opposite direction. He stresses that there is a need of better balance, one in which senior residents can truly become team leaders and prepare for independent decision-making, and attending physicians can supervise, teach, and provide direct care when needed. This balance will only be achieved if faculty acknowledge the uncomfortable truth: what was once considered micromanaging is now routine.