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Commentary |

Will Physician-Level Measures of Clinical Performance Be Used in Medical Malpractice Litigation?

Aaron S. Kesselheim, MD, JD; Timothy G. Ferris, MD, MPH; David M. Studdert, LLB, ScD, MPH
JAMA. 2006;295(15):1831-1834. doi:10.1001/jama.295.15.1831.
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Interest in quality measurement of physician performance is increasing.1 Patients seek ways to identify superior and inferior clinicians,2 and moves by health insurers and other purchasers toward “pay for performance” incentive systems are increasing demand for ways to identify and reward excellent or improving clinicians.3 One way to evaluate physician quality is through physician clinical performance assessment (PCPA), defined as “the quantitative assessment of physician performance based on the rates at which their patients experience certain outcomes of care and/or the rates at which physicians adhere to evidence-based processes of care.”1 Physician clinical performance assessment programs have been developed by payers, physician professional organizations, and consumer advocacy groups. At the national level, the Centers for Medicare & Medicaid Services and the National Quality Forum have also been active in fostering such initiatives.4

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Figure. Relationship Between Measures of Physician Clinical Performance and Likelihood of Admissibility as Evidence
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Although the measures for the Tufts Health Plan Physician Group and the MHQP Physician Network Quality Report currently aggregate physicians at the practice level, they are evaluated in the context of this chart as if they were extended to the individual physician. ADA indicates American Diabetes Association; CABG, coronary artery bypass graft; and MHQP, Massachusetts Health Quality Partners.



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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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