A Call to Action — Measuring the Quality of Colonoscopy

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Abstract
Several years ago I visited the Ming Tombs near Beijing. The Ming emperors were buried in elaborate structures, hidden away in the hills to prevent looting. Bricks were embedded with the signature of the brick maker. My guide told me that if the brick collapsed during the life of the brick maker, he would be beheaded. Needless to say, the tombs still survive, many centuries later.This variation on pay for performance (i.e., death for poor performance) highlights issues of quality. In medicine, focusing attention on quality improvement has given rise to systems for measuring quality, including the Health Plan . . .