Abstract

The editorial staff of the Southern Medical Journal is pleased to present this special issue on quality care and patient safety to the readership of the Journal. During the past decade, important issues in clinical medicine have received renewed emphasis in American health care, including evidence-based medicine, quality-of-life issues, patient safety and preventive safety nets, defining and assessing the quality of health care, patient satisfaction reporting, clinical competency and outcomes, shared decision making, and many others. Although these are not issues new to health care, the linking of these issues to reimbursement, physician ratings, and possibly professional credentialing is indeed unique. Modern clinical medicine has always been predicated on the individual physician’s commitment to excellent care of patients and to the active diminishment of adverse outcomes—that is, beneficence and nonmaleficence. Patient autonomy in personal healthcare decisions is now the prime ethical fundamental in this country. The fourth ethical fundamental element—social justice—remains an elusive goal in many parts of the United States, although advances clearly are being made to improve healthcare access and quality care for all.