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Previous Volume 335:50-51 July 4, 1996 Number 1 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Competing philosophies about the desirability of change confront managers, business leaders, politicians, and even medical editors. The common-sense advice of Bert Lance, President Carter's director of the Office of Management and Budget — "If it ain't broke, don't fix it" — stands in dramatic contrast to the modern tenets of quality improvement. These ideas about quality, introduced into medicine in the past decade but familiar in business circles for more than 30 years, reject the status quo and promote ideas such as ongoing product assessment, the identification of features that might be enhanced, and continuous improvement.¹ At the Journal, we . . . [Full Text of this Article]

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