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In Reply: We analyzed the "inculpatory" potential of PCPA data—that is, the likelihood that such data may be used against physicians in malpractice litigation. Based on an analysis of the law of evidence, we concluded that this is unlikely. Dr Luft raises the possibility of "exculpatory" uses. Could physicians deploy their own PCPA data to defend against malpractice claims? For proponents of PCPA, particularly those working to overcome physician resistance to these measures, Luft's notion is a hopeful one. However, the law is not on his side.

Physician clinical performance assessment highlights patterns of care for practitioners or groups of practitioners. Because PCPA is not directly connected to the particular issue in dispute, it constitutes "other act" evidence, akin to litigants' past behavior or known character traits. Civil courts have generally ruled this type of evidence inadmissible irrespective of which side seeks to introduce it. The rationale is that indirect . . . [Full Text of this Article]

Aaron S. Kesselheim, MD, JD
akesselheim@partners.org
Division of Pharmacoepidemiology and Pharmacoeconomics
Brigham and Women's Hospital

David M. Studdert, LLB, ScD, MPH
Department of Health Policy and Management
Harvard School of Public Health
Boston, Mass

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