There’s No Metric For What We Actually Do

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Value-based care loves a metric. Asthma Scores. Readmission rates. Screening completion. Every insurance model that claims to reward quality over volume is, underneath it, a spreadsheet. And spreadsheets need numbers.

So what happens to the things that don’t produce a number?

There’s no metric for talking to a scared, vaccine-hesitant family through their fears slowly enough that they actually come around — not because I lectured them, but because they trusted me. There’s no metric for answering a message at 7 PM instead of letting it sit until the next morning, and that one decision being the difference between a worried parent staying home and the same family sitting in an ER for six hours. There’s no metric for going to a newborn’s home to give a vitamin K shot after it was not given in the nursery due to the family being overwhelmed.

None of that shows up in a quality report. None of it gets reimbursed. All of it changes outcomes.

This is the blind spot in value-based care. It was built to measure what’s measurable, and somehow those numbers are the value. But the relationship between a doctor and a family isn’t a data point. It’s the true value of medicine and how it needs to be practiced. Strip away the relationship and all the numbers can be beautiful at a board meeting but at the end of the day garbage in, garbage out.

DPC physicians know this because we live it every day. We see the difference in the outcomes of our patients.

Maybe that’s the point worth making to the people building these models: before you can measure quality, you have to admit that some of the most important parts of it were never going to fit in a spreadsheet.

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About Daniel Dvoskin, DO

Dr. Dvoskin, known to most patients as “Dr. Daniel,” was born in Ukraine and immigrated to Brooklyn, New York, where he spent his early childhood. Fluent in English and Russian, he earned a Bachelor of Science in Biological Science from Florida International University and a Doctor of Medicine from William Carey University College of Osteopathic Medicine in Hattiesburg, Mississippi. Dr. Daniel launched his pediatric medicine career at Baylor Scott & White McLane Children’s, where he completed his residency in 2022. He worked with Texas Children's Hospital until he started his current direct pediatric primary care practice. He has a passion for forming relationships with patients and watching them grow alongside their families. When not seeing patients, Dr. Daniel enjoys spending family time with his family: his wife, an optometrist in Hutto, and their daughters. His other hobbies include creative writing and automotive sports. Community outreach is important to Dr. Daniel, and he looks forward to planting roots in the Taylor area.