Physician Performance and Its Effects on Patients

Nine thousand one hundred fifteen summary reports of patient care episodes were obtained from 2,342 practicing specialists in internal medicine, surgery, pediatrics, and obstetrics-gynecology. Each report described an episode of care in which directly observed or verifiable physician actions had clearly beneficial or detrimental effects on a particular patient. These reported “critical” physician actions and the patient end results attributed to these actions were inductively classified. These classifications contribute to the development of more systematic and objective criteria of effective physician performance. Certain findings in this study suggest that in specialty practice effective and ineffective physician performance may be evenly distributed; neither is more frequent in any particular age or sex grouping of patients, nor in disorders affecting any particular body systems.