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—The letters from Drs Matz and Sibert underscore the importance of reevaluating both credentialing procedures and the certification of postgraduate training programs to ensure that financial incentives to advance implementation of new technologies do not override the more fundamental concern for patient safety. These are not simple tasks, and to the extent they challenge medical staffs or professional organizations to approach their professional oversight responsibilities more stringently or in a faster time frame, they will undoubtedly cause anxiety. But the failure to establish patient safety as the litmus test—even when patients themselves are demanding the latest unproven treatment options— has a huge downside risk. In addition to increased exposure to a malpractice claim, patients become less trusting of the profession over the long run, and payers find more justification to encroach—whenever it is in their self-interest—on the physician's unique role in determining what constitutes appropriate care. Dr Caropreso
Hatlie MJ. The Learning Curve-Reply. JAMA. 1994;271(11):825. doi:10.1001/jama.1994.03510350032028