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To the Editor: The article by Drs Leape and Berwick¹ discussed what has happened in the 5 years since publication of the IOM report and why improvements have not been as great as hoped. Their discussion of the "culture of medicine" as a "daunting barrier to creating the habits and beliefs . . . that a safe culture requires" is sobering. We were therefore disappointed that there was no consideration of medical schools and their influence on the culture of medicine in the article. While the authors call for the Agency for Healthcare Research and Quality (AHRQ) to bring together the lead organizations to agree on a set of explicit and ambitious goals for patient safety to be reached by 2010, neither the Association of American Medical Colleges (AAMC) nor the Liaison Committee on Medical Education is mentioned.

Many of the AHRQ-funded researchers developing the foundations for safe practice are in academic health centers . . . [Full Text of this Article]

Joseph L. Halbach, MD, MPH; Laurie Sullivan, PhD, CSW
laurie_sullivan@nymc.edu
Department of Family Medicine
New York Medical College
Valhalla

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