Doctor performance and public accountability.

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Bibliographic Details
Title: Doctor performance and public accountability.
Authors: Lanier, David C., Roland, Martin, Burstin, Helen, Knottnerus, J. André
Source: Lancet. 10/25/2003, Vol. 362 Issue 9393, p1404-1408. 5p.
Subjects: Medical care, Medical personnel, Higher education, Professional peer review
Abstract: Public concern about the quality of health care has motivated governments, health-care funders, and clinicians to expand efforts to improve professional performance. In this paper, we illustrate such efforts from the perspective of three countries, the UK, the USA, and the Netherlands. The earliest strategies, which included continuing professional education, clinical audits, and peer review, were aimed at the individual doctor, and produced only modest effects. Other efforts, such as national implementation of practice guidelines, effective use of information technologies, and intensive involvement by doctors in continuous quality-improvement activities, are aimed more broadly at health-care systems. Much is yet unknown about whether these or other strategies--such as centralised supervision or regulation of quality improvement, or use of financial incentives--are effective. As demands for greater public accountability rise, continuing performance improvement efforts of each of our countries offer us opportunities to learn from one another. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
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Abstract:Public concern about the quality of health care has motivated governments, health-care funders, and clinicians to expand efforts to improve professional performance. In this paper, we illustrate such efforts from the perspective of three countries, the UK, the USA, and the Netherlands. The earliest strategies, which included continuing professional education, clinical audits, and peer review, were aimed at the individual doctor, and produced only modest effects. Other efforts, such as national implementation of practice guidelines, effective use of information technologies, and intensive involvement by doctors in continuous quality-improvement activities, are aimed more broadly at health-care systems. Much is yet unknown about whether these or other strategies--such as centralised supervision or regulation of quality improvement, or use of financial incentives--are effective. As demands for greater public accountability rise, continuing performance improvement efforts of each of our countries offer us opportunities to learn from one another. [ABSTRACT FROM AUTHOR]
ISSN:01406736
DOI:10.1016/S0140-6736(03)14638-7