I teach meteorology and flight ops in Canada, where we always use QNH below FL180, and call it "the altimeter setting."
If I'm asked why we don't use QFE, I explain that it isn't physically possible to set the altimeter to zero at many airports, and that the British only use it because they live on a small flat island and don't know how to subtract.
Honestly, it quickly becomes second nature to subtract the aerodrome elevation from the indicated altitude. That winding down to zero bit won't help you much if you turn the wrong way in the missed, and hit a two thousand foot hill, anyway.