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October 13, 1999

Health Care Service Quality—Reply

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor


Copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1999

JAMA. 1999;282(14):1330-1331. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-14-jbk1013

In Reply: Dr Porter suggests that our article describes a simple case of a single physician's "inexcusable" naiveté, coupled with the patient's failure to prepare for the visit. This is a classic approach to mistakes in health care: blame the individuals and move on, but unfortunately, we get nowhere. Although my physician and I contributed to the problem, focusing on blame distracts attention from why things went wrong and how we might correct them. Taking Porter's cue, perhaps understanding how we each contributed would allow us to learn about the real causes of the problem and to work on correcting those causes.1 Otherwise, we are doomed to repeat the errors.

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