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Medicare: New Directions in Quality Assurance Proceedings (1991)

Chapter: Part 2: New Directions: More Professionalism, Less Regulation

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Suggested Citation:"Part 2: New Directions: More Professionalism, Less Regulation." Institute of Medicine. 1991. Medicare: New Directions in Quality Assurance Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/1768.
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PART II
New Directions: More Professionalism, Less Regulation

Suggested Citation:"Part 2: New Directions: More Professionalism, Less Regulation." Institute of Medicine. 1991. Medicare: New Directions in Quality Assurance Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/1768.
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Suggested Citation:"Part 2: New Directions: More Professionalism, Less Regulation." Institute of Medicine. 1991. Medicare: New Directions in Quality Assurance Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/1768.
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New Directions: More Professionalism, Less Regulation

Introduction

William S. Hoffman

This part of the conference proceedings is entitled ''More Professionalism, Less Regulation.'' The professionalism that the study committee described and discussed was not the aspect or dimensions of professionalism that are more associated with secret, perhaps elite, concerns that might be called trade association economics or the exclusivity of a profession. Rather, we were talking about the more virtuous aspects of professionalism—the assumption that an individual wants to grow not only as an individual, but with the science and in his or her commitment to patients. It is that kind of professionalism that we will be discussing. Committee member Leo M. Cooney, Jr., M.D., Humana Foundation Professor of Geriatric Medicine at Yale University School of Medicine, presents the committee's views; Lonnie Bristow, an internist in the private practice of medicine in California, offers a response. In much of the committee discussions there was a continuum of concerns. Commitment to individual growth, a collegial atmosphere, moving from legalism and detecting problems as opportunities for improvement—all of this ran through committee discussions. At the same time, none of us was comfortable enough to come out fully and say there are examples of quality assurance systems based solely on this notion of professionalism that will work throughout the whole system of health care. Generally, current quality assurance programs tend to place more emphasis on costs, utilization, and on detection and control, and less emphasis on professional growth, outcomes, and improvement of health. We have to find a point between rigid regulation at one end of the continuum and unexamined professionalism at the other.

Suggested Citation:"Part 2: New Directions: More Professionalism, Less Regulation." Institute of Medicine. 1991. Medicare: New Directions in Quality Assurance Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/1768.
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Page 15
Suggested Citation:"Part 2: New Directions: More Professionalism, Less Regulation." Institute of Medicine. 1991. Medicare: New Directions in Quality Assurance Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/1768.
×
Page 16
Suggested Citation:"Part 2: New Directions: More Professionalism, Less Regulation." Institute of Medicine. 1991. Medicare: New Directions in Quality Assurance Proceedings. Washington, DC: The National Academies Press. doi: 10.17226/1768.
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Page 17
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Medicare: New Directions in Quality Assurance Proceedings Get This Book
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This book contains chapters and commentaries by members of the Institute of Medicine (IOM) committee and by outstanding practitioners, researchers, legislators, and policymakers about the IOM's proposals for new directions in quality assurance as specified in Medicare: A Strategy for Quality Assurance, Volumes 1 and 2.

Sections of this new book address ideas about how to move toward increasing professionalism, implementing orgranization and system-focused quality improvement, better decision making by patients and clinicians, patient outcomes orientation, and public accountability and program evaluation. Other sections explore research questions and capacity building in the field of quality assessment and improvement, the epidemiology and quality problems, and legal issues in quality assessment.

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