To the Editor.—
The article entitled "Quality Medical Care"1 contains misconceptions about the terms quality, capacity, and outcome. Subverted language subverts perceptions, understanding, and, last but not least, policy.At just about the same time the Medical Tribune reported in a news brief (June 30, 1988) that Dr Paul Ellwood, president of Inter Study, proposed a "national computerized outcomes analysis"; that Dr Arnold S. Relman, editor of the New England Journal of Medicine, termed outcome analysis "potentially the third revolution of medicine"; and that Dr William Roper, administrator of the Health Care Financing Administration, announced a government study of "quality of care" rating for each of the 280 000 physicians treating Medicare patients and that eventually patients would be steered to "quality doctors."First, there is an article taking liberties with the facts, followed by a "computerized outcomes analysis" constituting a "revolution," and, finally, a policy to label physicians.