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To the Editor: Dr Kiefe and colleagues¹ reported that physician performance could be improved by giving physicians feedback linked to attainable benchmarks. Even among physicians who received the intervention, however, 42% of patients did not receive the influenza vaccine. Physicians also did not meet the benchmarks for foot examination (39%), glucose control (30%), and cholesterol and triglyceride levels (28% and 35%, respectively).

This is a dismal record of performance. Most patients have heard of these tests from popular media such as newspapers and television. Traditional continuing medical education with the award of category I credits has not solved the problem. Specialty societies have recertification programs, which is a step in the right direction. However, measurable physician performance is what is required. In the article by Kiefe et al, Medicare claims data provided this information, and managed care organizations and other insurance companies can generate similar information.

If physicians risk elimination . . . [Full Text of this Article]

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