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CMAJ • February 19, 2002; 166 (4)
© 2002 Canadian Medical Association or its licensors

Letters
Correspondance

Interplanetary health care report cards

Vincent Richman

Research Associate AlgoPlus Consulting Limited Halifax, NS

Jack Tu and colleagues raise important issues concerning the interpretation of health care report cards.1 In addition to writing science fiction about interplanetary travel and life on other planets, Edgar Rice Burroughs speculated about effective medical performance evaluation systems.2

In The Pirates of Venus, Burroughs created a world in which various forms of intelligent life formed city-states that were in a continual state of conflict. Medical sera prolonged life indefinitely. The primary role of physicians was to treat injuries resulting from accidents and battles.

Burroughs described an ongoing physician performance evaluation system in which all physicians were required to report the course of treatment and resulting outcomes for every patient. These reports were filed with a central agency and were made available to the public.

The Burroughs system addresses many of the concerns raised by Tu and colleagues by making the physician report on his or her own cases. The quality of the data and the risk-adjustment process, the completeness of the chart, and the accuracy of the full story on both process and outcomes are all the responsibility of the physician. These reports by physicians constitute an early example of providing administrative records for an external entity. Although the reports lack standardized measures of disease severity, health status or quality of life, Burroughs' system offers a first step toward accountability and quality improvements.

References

  1. Tu JV, Schull MJ, Ferris LE, Hux JE, Redelmeier DA. Problems for clinical judgement: 4. Surviving in the report card era. CMAJ 2001; 164 (12):1709-12.[Abstract/Free Full Text]
  2. Burroughs ER. The pirates of venus. New York: Dover Publications; 1932.




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