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November 1997

Quality of Care in Dermatology: The State of (Measuring) the Art

Author Affiliations

Department of Dermatology and the UCSF-Mt Zion Center on Aging University of California, San Francisco San Francisco Veterans Affairs Medical Center 111 (G) 4150 Clement St San Francisco, CA 94121 (e-mail: mmchren@orca.ucsf.edu)

Arch Dermatol. 1997;133(11):1349-1351. doi:10.1001/archderm.1997.03890470021004

WHY A theme issue on quality of care? Most dermatologists probably believe that the quality of our care has never been better. The problem is that we now have to prove what before we may have accepted on faith. To do that, we must agree on what quality is and we must measure it accurately.1

Ironically, many physicians are ambivalent about the current preoccupation with measuring quality of care. In the past, simply the implicit commitment of each physician to try to choose the best care for each patient seemed sufficient. Now we not only must answer in more formal and public ways about our care but also our answers must include precise gauges of what we had heretofore assumed was part of the art of medicine (and which, like all art, defies measurement).

What has happened, of course, is that decision making in health care has become more