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Previous Volume 355:2588-2589 December 14, 2006 Number 24 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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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 . . . [Full Text of this Article]

Source Information

From the Division of Gastroenterology, Oregon Health and Science University, Portland Veterans Affairs Medical Center, Portland.

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