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Defining quality in medical care.

Prologue: The quality of medical care rendered by physicians in and outside of hospitals has become a subject of increasing public and, more recently, private-sector concern. Until quite recently, third-party payers were reluctant to question the medical decisions of physicians, recognizing that medicine is a complex equation and that one of the hallmarks of a profession is self-regulation. Beyond the issue of professional autonomy, though, is the reality that “quality” is defined differently by different interests. In this paper, Philip Caper discusses the evolution of federal involvement in the pursuit of quality, noting that organized medicine has never been bashful about employing the quality argument in an effort to thwart health policy thrusts that it opposed. Caper is well equipped as a physician and a policy analyst to discuss issues revolving around the quality of care. He was a professional staff member of the Senate Labor and Human Resources (then Labor and Public Welfare) Subcommittee on Healt...