Effects of Outcome on Physicians' Judgment of Appropriateness of Care

Robert A. Caplan, MD; Karen L. Posner, PhD; Frederick W. Cheney, MD
JAMA. 1991;266(6):794. doi:10.1001/jama.1991.03470060055013.
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In Reply.  —We wholeheartedly agree with Woods and Cook. Recognizing the presence and potential magnitude of outcome bias in physician judgments creates a healthy stimulus for improving the process of retrospective case review. Such improvements will benefit not only the patient and the physician, but also the much broader group of individuals and institutions who engage in the design, provision, and financing of health care.It is important—and exciting—to recognize that effective remedies may be close at hand. As Woods and Cook point out, some of the fundamental concepts and tools for managing outcome bias have already been explored in the literature of experimental psychology and human performance. The next logical step will be to determine whether this basic knowledge can be effectively adapted and extended to meet the specific needs of health care analysis.


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