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January 11, 1985

The Ultimate Audit

Author Affiliations

Lancaster, NH

JAMA. 1985;253(2):199. doi:10.1001/jama.1985.03350260045012

To the Editor.—  The problem of the decline in hospital autopsies from the point of view of a general pathologist serving small community hospitals (<100 beds) in a rural setting is not one of reimbursement for the autopsy or one of lack of physician interest.1 It is rather the reaction by the medical staff physicians to a litigious social climate. In New Hampshire, where malpractice suits are frequent and malpractice insurance premiums are escalating at an astounding rate, the medical staff members I know do not want discoverable factual records of any inadvertent or misadventurous error in diagnosis or treatment of their patients to be recorded by the pathologist in the "ultimate audit." Therefore, I am most surprised that the American Bar Association's (ABA) spokesman, Mr Gonser, was so reluctant to commit himself in response to the telephone questionnaire on the autopsy.2I would have thought that the