IMITATING THE MAYO CLINIC.

IMITATING THE MAYO CLINIC. One of the problems that Gutwande finds in McAllen is harmful financial incentives, but those incentives are the same in El Paso and in other cities with lower medical costs. There also seems to be a considerable body of research studying whether particular procedures are unnecessary or don’t provide benefits greater than their costs. But Gutwande proposes to go farther. He would like to see studies made of how the Mayo Clinic and other good hospital systems succeed at delivering high quality care at low cost. He says: “This will by necessity be an experiment. We will need to do in-depth research on what makes the best systems successful—the peer-review committees? recruiting more primary-care doctors and nurses? putting doctors on salary?—and disseminate what we learn…. [W]e …. need to fund research that compares the effectiveness of different systems of care—to reduce our uncertainty about which systems work best for communities. As I indicated, it is surprising that apparently not much of this kind of research has been done.