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The Unintended, Negative Consequences of the Door-to-Antibiotic Measure for Pneumonia
- Robert M. Wachter, MD;
- Christopher Fee, MD; and
- Scott A. Flanders, MD
- From University of California, San Francisco, San Francisco, CA 94143, and University of Michigan, Ann Arbor, MI 48109.
IN RESPONSE:
We appreciate the letters, which endorse our main premise while adding new data and insights. Although we agree with most of the authors' points, we worry that the experience of a flawed measure, such as door-to-antibiotics for pneumonia, will lead some to throw out the baby (quality measurement and transparency) with the bathwater (the bad measure).
For example, Dr. Dean argues that the imposition of a national standard for pneumonia care undermined his organization's homegrown pneumonia strategy. We agree that national guidelines should provide enough …
