During a period of enforced idleness I have been attempting to catch up with my reading pile. May's Journal included a paper that made a sweeping generalisation in a throw-away fashion. I refer to Houghton and Rouse' paper on performance indicators as markers of GP quality1 and the boxed ‘How this fits in’ comment that we already know that GPs ‘tend to find externally imposed measurements irrelevant and threatening’.
The original papers referred to2-5 do not support this assertion; the most relevant citation is from 1995 and has been superseded. The most up to date is an editorial. A quick search on Medline for ‘performance indicators’ and ‘primary care’ generated four more recent citations (not including the one being discussed). Indeed, more recent reactions to performance indicators are more favourable,6 though admittedly there were concerns about the quality of the data itself. It is not Houghton and Rouse's paper per se that I object to — simply the over-generalisation and selective use of references. GPs need to be accountable and we need to find ways of ensuring that what is counted counts. Not that we count merely what can be counted. Such generalisation that all GPs feel threatened perpetuates the myth that we don't feel we should be accountable.
- © British Journal of General Practice, 2004.