Historically, there have been 3 pillars of quality assurance in health
care: self-regulation by hospital credentialing committees, malpractice litigation,
and external regulation by licensure boards.1
Hospital oversight of credentials and privileges dates to the early part of
this century and reflects the professional commitment to and enjoyment of
self-regulation. Malpractice litigation, on the other hand, is a counterpoint
to professional self-regulation. As with all tort law, malpractice is intended
to deter poor-quality care by fixing economic sanctions onto practitioners
who injure patients as a result of negligence.2
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