Making medical practice safer: The role of public policy

Abstract

Health care quality and safety is a public policy issue. In the past, issues of quality of care have been largely delegated to the medical profession. Now, however, governments may wish to assume a more active role and will need to know what governance tools are likely to be effective. This paper reviews the evidence on effectiveness for seven processes for governing the physician sector: informing; guiding; educating; reporting; incentivizing; re-licensing; and punishing. There is good evidence for modest to moderate effectiveness of the first three approaches, scant evidence for the next two, and no empirical data on the final two.