The medical profession has been required to surrender its autonomy step by step since the late middle ages. This is a discussion of the history and future of medical malpractice. (Author/BB)

Evaluation of the efficacy of a medical intervention requires measurements of both its benefits and risks as compared to those of alternative forms of management. The requisite measurements are more difficult to make than this description suggests, and the accumulation of information is inhibited by certain characteristics of our pattern of health…

In spite of remarkable advances in medical therapy and in the development of fantastic diagnostic devices, American society appears increasingly disenchanted with the physician. Some of the reasons for this paradox are discussed in this article. (BB)

Defensive medicine (the use of diagnostic and end-treatment measures explicitly for the purposes of averting malpractice suits) is frequently cited as one of the least desirable effects of the current rise in medical litigation. It is claimed that defensive medicine is responsible for the rising cost of health care and the exposure of patients to…

Methods for assessing and monitoring the quality of care for research and for quality assurance programs are discussed. (Author/BB)

Early clinical trials (observational or randomized) hasten the prompt evaluation of new operations. Early clinical surveillance facilitates the design and implementation of randomized clinical trials when they are necessary. Long-term surveillance of operations allows continuing evaluation when their use becomes widespread. (BB)

Discusses the rising trend supporting for-profit hospitals. Compares for-profit and not-for-profit hospitals in regards to hospital costs, quality of care, care for the poor, education and research, and the role of the physician. (TW)