Abstract
Of the many issues now confronting medical professionals, none seems more perplexing than the debate about the quality of care. Just a few years ago, physicians could be confident that they alone had a social mandate to judge and manage the quality of care. Now, that mandate is contested daily in industrial boardrooms, legislative-hearing rooms, and even medical-consultation rooms. The very language of current discussions about the quality of care leaves many physicians tongue-tied and uncomprehending: observed and expected mortality, outcomes and process measures, SF-36, case-mix and case-severity adjustments, profiles, HEDIS measures, control charts, continuous quality improvement, total quality management, . . .
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