Is "quality of care" being mislabeled or mismeasured?

According to Francis Peabody, "The secret of the care of the patient is in caring for the patient." This secret has been well guarded in current approaches to measuring "quality of care." The measurements have concentrated on performance of approved technical procedures, such as the appropriate ordering of diagnostic tests, pharmaceutical agents, or surgery, but have generally ignored traditional components of caring, such as relieving pain or other symptoms, improving functional capacity, and assuaging anxiety or distress. By ordering the pertinent technical procedures, a health care system, institution, or clinician can get excellent ratings for "quality of care," despite gross violations of human caring. Although offering desirable assurance that the best procedures are being used, the current measurements need a more accurate label, such as "quality of technical performance." If the process of caring is to be emphasized and appraised appropriately, new methods will be required. They can be developed to identify specific activities in caring and perhaps to include evaluations of accomplishment for what patients say they want done.