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Review

Problems for clinical judgement: 4. Surviving in the report card era

Jack V. Tu, Michael J. Schull, Lorraine E. Ferris, Janet E. Hux and Donald A. Redelmeier
CMAJ June 12, 2001 164 (12) 1709-1712;
Jack V. Tu
From the *Department of Medicine, University of Toronto, Toronto, Ont.; the †Division of Clinical Epidemiology and Health Care Research, Sunnybrook & Women's College Health Sciences Centre, Toronto, Ont.; the ‡Departments of Health Administration and Public Health Sciences, University of Toronto, Toronto, Ont.; and the §Institute for Clinical Evaluative Sciences, Toronto, Ont.
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Michael J. Schull
From the *Department of Medicine, University of Toronto, Toronto, Ont.; the †Division of Clinical Epidemiology and Health Care Research, Sunnybrook & Women's College Health Sciences Centre, Toronto, Ont.; the ‡Departments of Health Administration and Public Health Sciences, University of Toronto, Toronto, Ont.; and the §Institute for Clinical Evaluative Sciences, Toronto, Ont.
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Lorraine E. Ferris
From the *Department of Medicine, University of Toronto, Toronto, Ont.; the †Division of Clinical Epidemiology and Health Care Research, Sunnybrook & Women's College Health Sciences Centre, Toronto, Ont.; the ‡Departments of Health Administration and Public Health Sciences, University of Toronto, Toronto, Ont.; and the §Institute for Clinical Evaluative Sciences, Toronto, Ont.
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Janet E. Hux
From the *Department of Medicine, University of Toronto, Toronto, Ont.; the †Division of Clinical Epidemiology and Health Care Research, Sunnybrook & Women's College Health Sciences Centre, Toronto, Ont.; the ‡Departments of Health Administration and Public Health Sciences, University of Toronto, Toronto, Ont.; and the §Institute for Clinical Evaluative Sciences, Toronto, Ont.
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Donald A. Redelmeier
From the *Department of Medicine, University of Toronto, Toronto, Ont.; the †Division of Clinical Epidemiology and Health Care Research, Sunnybrook & Women's College Health Sciences Centre, Toronto, Ont.; the ‡Departments of Health Administration and Public Health Sciences, University of Toronto, Toronto, Ont.; and the §Institute for Clinical Evaluative Sciences, Toronto, Ont.
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  • Medical Report Cards: Science fiction from Edgar Rice Burroughs is relevant to the present
    Vincent Richman
    Posted on: 02 August 2001
  • Posted on: (2 August 2001)
    Page navigation anchor for Medical Report Cards: Science fiction from Edgar Rice Burroughs is relevant to the present
    Medical Report Cards: Science fiction from Edgar Rice Burroughs is relevant to the present
    • Vincent Richman, Research Associate
    Tu et al. [1] raise important issues to consider when interpreting report card evaluations. Edgar Rice Burroughs as well as writing science fiction about interplanetary travel and life on other planets, also speculated about effective medical performance evaluation systems [2]. Burroughs described an ongoing physician performance evaluation system in which all physicians were required to report the course of treatment and resul...
    Show More
    Tu et al. [1] raise important issues to consider when interpreting report card evaluations. Edgar Rice Burroughs as well as writing science fiction about interplanetary travel and life on other planets, also speculated about effective medical performance evaluation systems [2]. 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 for the public to consult. By making the physician report his own cases, the Burroughs system addressed many of the concerns raised by Tu et al. First the messenger was the physician himself. Second, the quality of data, the risk adjustment process, the completeness of the chart, the outcomes and the full story of both process and outcomes were all provided by the physician.

    Vincent Richman
    Research Associate
    AlgoPlus Consulting Limited
    Halifax, NS

    VRichman@hotmail.com


    [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.

    [2] Burroughs ER. The Pirates of Venus. New York: Dover Publications. 1932.
    Show Less
    Competing Interests: None declared.
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Vol. 164, Issue 12
12 Jun 2001
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Problems for clinical judgement: 4. Surviving in the report card era
Jack V. Tu, Michael J. Schull, Lorraine E. Ferris, Janet E. Hux, Donald A. Redelmeier
CMAJ Jun 2001, 164 (12) 1709-1712;

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Problems for clinical judgement: 4. Surviving in the report card era
Jack V. Tu, Michael J. Schull, Lorraine E. Ferris, Janet E. Hux, Donald A. Redelmeier
CMAJ Jun 2001, 164 (12) 1709-1712;
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  • Article
    • Abstract
    • 1. Don't shoot the messenger
    • 2. Check that the results are risk-adjusted
    • 3. Check the quality of the data prior to analysis
    • 4. Ask if the authors have conflicts of interest
    • 5. Know your outcomes before others do
    • 6. Complete your charts carefully
    • 7. Focus your practice
    • 8. Learn from your colleagues
    • 9. Ask for the full story of both process and outcomes
    • 10. If you can't beat them, join them
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