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To Report or Not Report

Troyen A. Brennan, MD, JD, MPH

JAMA. 1999;282:381-382.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Historically, there have been 3 pillars of quality assurance in health care: self-regulation by hospital credentialing committees, malpractice litigation, and external regulation by licensure boards.¹ Hospital oversight of credentials and privileges dates to the early part of this century and reflects the professional commitment to and enjoyment of self-regulation. Malpractice litigation, on the other hand, is a counterpoint to professional self-regulation. As with all tort law, malpractice is intended to deter poor-quality care by fixing economic sanctions onto practitioners who injure patients as a result of negligence.²

The third oversight mechanism, regulation by licensure boards, also has strong professional influence, so much so that the most radical recommendation in the recent Pew Commission report on regulation of health care quality was that licensure boards should move to one-third nonprofessional membership.³ Nonetheless, the boards are usually independent regulators of physician practice, focusing sanctions particularly on . . . [Full Text of this Article]

Author Affiliations: Harvard School of Public Health, Harvard Medical School, Boston, Mass.

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