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A Piece of My Mind
August 12, 1998

In a Word

JAMA. 1998;280(6):493-494. doi:10.1001/jama.280.6.493

With the advent of managed care in the United States, the conversation over the direction of medicine (as an industry and as a practice) has become laden with terms heretofore unfamiliar to the majority of health care professionals. These business concepts may be relatively new to the discourse concerning health care, but they have long been standard fare in the discussion of effective corporate management, specifically with respect to W. E. Deming's precepts of "total quality improvement." These precepts have been widely applied to systems of health care, with what have been reported as beneficial results. Borrowing from the language of corporate management has provided a new way to articulate age-old frustrations of patients with existing systems of care delivery and has helped to point the way toward improving care with a variety of forward-thinking and laudable concepts, such as improving overall patient satisfaction, reducing the use of unnecessary procedures or tests, and restructuring payment schedules to reward those who emphasize preventive, rather than reparative, interventions.

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