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Previous Volume 342:519-520 February 17, 2000 Number 7 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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To the Editor: Casalino (Oct. 7 issue)¹ provides a voice for physicians who hold the intuitive conviction that tables of specialty-referral rates, formulary compliance, and hospitalization rates represent a subtle but nonetheless unacceptable diversion of the physician's focus from the life-and-blood patient to the gamesmanship of documentation. According to Heisenberg's uncertainty principle, as applied to the measurement of quality in health care, one cannot gather sufficient information about a physician's activities (the "object's position") to determine the quality of care being provided without distorting the physician's professionalism (the "object's velocity") — that is, without distorting the physician's attitudes, motivation, and . . . [Full Text of this Article]

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