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Dr. Gross has an opinion. He has that right.

So the State sets a standard which may or may not be a valid one. The State then says that we will impose that standard, measure that standard, and declare that non-compliance with that standard is "inadequate care".

I guess Dr. Gross agrees that being managed by the State is OK.

My contention is that the State is not there when you bring your sick child to the ER at 3 am, nor when you need an examination for your severe rectal pain. The State is real good, however, at imposing standards of care, even though the State Functionaries sit in offices from 9 to 5 and never put hands on patients. They of course find non-clinical doctors to "validate" these imposed standards, so they can say that these recommendations are from "doctors" who no doubt have imposing titles from the days that they actually treated patients. Some of those docs were probably pretty good, in the pre-penicillin era.

So much for "federal government prodding doctors toward improvement".

As for anesthesiologists, the improvements in technology you cite function merely to provide hard copy that everything was done correctly, making it harder for malpractice attorneys to unjustly point the finger at the doctors. The measures allow the docs to PROVE that proper safeguards were employed. Instead of just relying on their "word" that adequate oxygen was supplied to the patient at all times, a hard copy trace can be provided that PROVES it. The new measures you cite allow the doctor th document the good care he has been already providing for years, so the finger is not unjustly pointed at his "deep pockets" when bad outcomes occur.

Just because something is in the NYT doesn't mean it's true. Don't all of us on FR know that all too well?

Federal research for the sake of measuring medical quality is not the same as being managed by the state. The bad news is that quality is poor by some simple and useful measures. The good news is that doctors and hospitals are taking the information and using it to improve patient care.

As for anesthesiologists, I am freep mailing you an article from the British Medical Journal supporting the point that I made that technical improvements in anesthesiology have improved patient care and safety. The approach deserves wider use.

Has anyone connected the dots between Leape, the IOM, the Clintons and the trial lawyers? I remember when the IOM report first came out and (Bill) Clinton was gloating about it. Also, do you know of any studies that dissect Leape's bogus statistics?