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Michael D. Fetters, MD, MPH
University of Michigan Ann Arbor

JAMA. 1995;274(6):458.

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

To the Editor.

—Dr Leape¹ is to be congratulated for a highly needed and provocative analysis of error in medicine. Unfortunately, his article and the accompanying Editorial² largely ignore the patient's perspective. Unlike the manufacturing industry, where the product is an inanimate object, the product in medicine is quality health care. As autonomous individuals, patients are active participants in the process, not passive recipients. Based on my experience in completing in-flight consumer satisfaction surveys, I am convinced that consumer feedback is used extensively in the aviation industry. As the participant in and consumer of the health care product, patients have a priceless and unique perspective both on error prevention and on error resolution. Unfortunately, there is only sparse research and philosophical inquiry into patients' attitudes, values, and beliefs about the management of medical errors and mistakes.

Leape states, "[Tjotal quality management calls for grassroots participation to identify and . . . [Full Text PDF of this Article]

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