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March 21, 1977

A Question of Quality? Roads to Assurance in Medical Care

Author Affiliations

Yale University School of Medicine New Haven, Conn

JAMA. 1977;237(12):1266. doi:10.1001/jama.1977.03270390082036

A Question of Quality is valuable to the American physician because it looks at the problems of quality assurance from a different perspective, ie, that of a country with a National Health Service. Of particular interest are analyses of such professional matters as maternal health, the care of malignant hypertension, and the quality of surgical care. In an introduction and a postscript, which deserves wide reading, the editor has contributed valuable essays on the principles and perspectives of quality assurance. I like best an essay on quality in general practice. This emphasizes the way practicing physicians working together in small groups can learn to improve more readily than by preparing for formal tests of cognitive knowledge. Of course, there was no double-blind controlled study to prove this notion! As the writers keep pointing out, assessment depends so largely on recordkeeping that a good physician can be judged deficient simply because