To the Editor.—
The article by Woo et al1 on screening procedures in the healthy adult raises the issue of how to improve physician performance when using previously agreed on minimum standards (specific tests to be done or questions asked). Screening procedures expose one's inconsistencies—as by definition the procedure has been planned for a specific reason. Therefore, the failure to get the data or the response to the results when they are abnormal is conspicuous.
We reported a similar poor performance level by physicians when, by planning and agreement, the minimum history and physical data for treating patients with the specific problems of myocardial infarction, hip fracture, and cholecystitis were defined.2
There is a simple solution to this problem of failing to get the data, identical in practice to balancing one's financial accounts at the end of each day. The physician decides that he is to be accountable
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