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C. David Naylor, MD,DPhil

JAMA. 2002;287:1323-1325.

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

The Great Clinical Report Card Dream plays out along these lines . . . skulking in the shadows are the incompetent physicians and surgeons of Hospital X. Protecting them is a legion of spineless clinical managers and hospital administrators who purport to practice total quality management, continuous quality improvement, and other forms of self-evaluation and performance enhancement. In truth, their clinical processes remain flawed, and their outcomes are statistically beyond the pale.

Meanwhile, a fearless band of quality analysts has undertaken to shed light on the clinical performance of this and similar institutions. Accountability is their watchword. They meet all challenges with one phrase: "The public's right to know." They will reduce the information asymmetry between physicians and patients. They will challenge back-scratching referral networks and usher in a new era of medical meritocracy. They will save lives and money. They will carefully examine Hospital X's . . . [Full Text of this Article]

Author Affiliation: Faculty of Medicine, University of Toronto, MSB 2109, 1 King's College Circle, Toronto, Ontario.

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