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To the Editor: In their Commentary, Drs Kesselheim, Ferris, and Studdert¹ outline the reasons physician clinical performance assessment (PCPA) is unlikely to be a major concern to physicians involved in malpractice litigation. What they do not address, however, is whether PCPA may be effectively used by the defense in such cases.

As the authors point out, malpractice claims focus on the allegation that the clinician was negligent and that the alleged error caused harm. Although there are some cases in which evidence bearing on these 2 conditions may be clear (eg, a foreign body left in the abdomen after surgery), in most instances there is some uncertainty as to whether the correct choices were made, and whether the bad outcome might have occurred by chance.

Because part of the defense is to argue that the bad outcome was not clearly due to the alleged actions but may plausibly have occurred . . . [Full Text of this Article]

Harold S. Luft, PhD
hal.luft@ucsf.edu
Institute for Health Policy Studies
University of California, San Francisco