How to measure what is not measurable in medicine? – Corriere.it

In the most powerful computing center in the world, our group of experts has conducted an enormous work on the largest mass of data ever collected, thus arriving at the definitive ranking of the best hospitals in the world, the best doctors in the nation, the discoveries that will change our life! Raise your hand who, having come across similar announcements and having a health problem, has not searched these rankings the professional able to respond to your need. And don’t try to lower it if you are part of that list and haven’t deprived yourself of the bittersweet taste of seeing yourself above or below the level of your expectations. Effectively, it seems that classifications cannot be dispensed with, even and above all in medicine. What is true in this type of rankings, beyond the circumstantial words of the experts? Four centuries ago Galileo Galileifather of modern science, invited us to measure what is measurable and to make what is not measurable.

In fact, the measurement of nature has contributed to the advancement of scientific knowledge and has also fueled – as intuited by the Pisan genius – research on what is not measurable. The road has led to our present, where the DNA of every individual can be decoded and almost every practical action can be framed in an algorithm. In this context It’s hard to think that there are still entities that manage to escape the capture of a mathematical formula; on the other hand, ideas and personal judgments remain unmeasurable. To evaluate an artist, a writer, a chef or a sportsman, they are called judges and not computers, as if to say that what is objective is easily measurable while what is subjective is much less so. For doctors, the rankings must be interpreted, because there are too many, and conflicting, interests that measure their many faces. On the one hand there is the economic measure which classifies services, activity volumes, waiting times, costs. On the other hand, there is the scientific measure that sees innovation, prolificness and the publications that certify it.

But how to measure a doctor’s continuity of commitment, dedication, compassion, dialogue, attention to detail and to people’s needs? How to measure the risk or entrusting oneself with confidence to one’s patient, the attention to his fragility, the frustration of error and abandonment? These parameters, which the rankings do not capture, are well perceived by patients and their familiesthe true judges and true saviors of the doctor who tries to escape the anti-value grip that declassifies him as a simple provider of more or less complex technical services. So the people with their hand raised over there can also use the doctors’ rankings to obtain more credible information, not forgetting why measuring everything is not the same as knowing it and that biological life, ours, imperfect and unique, infinitely far from the clarity of a computer. Only by interlocking with those who observe and correct our distortions with a critical spirit and competence, is it generated the immeasurable taste of new-found health.

* University of Milan, National Cancer Institute of Milan