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Still finding ways to measure the quality of medical services and working to improve them is good practice. I thought the medical community already had internal methods to monitor aspects like surgeon performance or the adequacy of sterilization.

Why can't the medical community be self regulating in this regard too?

Why do they need an outside boost from govt or the insurance industry?

The medical community does self-regulate. But the best regulation is a free market with competition. Patients/consumers will choose the best option. This is far more efficient than trying to to optimize only specific measures. Health care providers focus on certain numbers rather than providing the best overall care. Some of these numbers can be good measures but only if considered within the framework of overall patient care.

Let's use an example. One measurement has been the time it takes to start antibiotics for pneumonia in the ER. The goal was set to start antibiotics within a certain number of hours. Unfortunately, this gives physicians incentives to start antibiotics unnecessarily in case somebody has an atypical presentation for pneumonia. Certain patients get a costly drug (which may kill them if they have a serious allergic reaction) which they may not even need. It also penalizes busy ER's where patients might have to wait before being seen (the clock starts ticking once the patient walks in the door). The health care providers might need to sacrifice more important care for a sicker patient in order to start antibiotics on somebody who may or may not need them.

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