You do a lot to manage patients with COPD. You carefully assess their symptoms, family history, exacerbations, medications, devices, compliance, etc. You even test for common respiratory comorbidities.
While these measures are vital to quality care, accounting only for them may be leaving quality on the table. Treating respiratory conditions alone accounts for the what, but not the why.
For instance, why is a patient smoking so much? Why is he failing to be adherent with therapy? Why is he skipping medical appointments? Questions like these point to a deeper treatment opportunity.