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November 18, 1992

Quality Assessment of Quality Improvement Programs

Author Affiliations

Puyallup, Wash

JAMA. 1992;268(19):2648. doi:10.1001/jama.1992.03490190048014

To the Editor.  —The article on peer review organization methods by Rubin et al1 was interesting and its results conform to my empiric observation and bias.It is also my bias that the detection of quality problems on the part of physicians is probably not of value. It is my opinion that most problems are recognized by the physician and self-corrected. It would also be my bias that mistakes occur at a relatively continuous level and that picking up a mistake does not change overall quality of care.I would be interested to know whether there has been any change in overall morbidity or mortality from the period before peer review organization review processes were instituted to the present. I suspect that there has been no substantive change in outcome as a result of peer review organization review processes.This same sort of outcome analysis that is starting to