Affiliations: Centre for Health Services and Policy Research, Queen’s University, Kingston, Canada | Department of Community Health and Epidemiology, Queen’s University, Kingston, Canada | Department of Family Medicine, Queen’s University, Kingston, Canada | Faculty of Law, Queen’s University, Kingston, Canada | Department of Political Science, Lakehead University, Thunder Bay, Canada
Note: [] Address for correspondence: S.E.D. Shortt, MD, PhD, Centre for Health Services and Policy Research, Queen’s University, Kingston, K7L 3N6 Canada. Tel.: +1 613 731 8610, ext 2010; Fax: +1 613 521 1268; E-mail: [email protected]
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.
Keywords: Patient safety, quality of care, physicians, governance
