Quality-of-care standards and professional norms

Incursions upon professional prerogatives are increasing with the advent of new requirements for accoutability; this has stemmed in part from the government's enlarged role in paying for mental health services. The author discusses the effect of professional norms on the assessment of quality of care, including the concepts of risk and autonomy, observability and privacy, the perspective of time, and the appropriateness of the penalty. He offers some suggestions for the design and implementation of quality-of-care standards that he believes will benefit both professionals and administrators, as well as protect the patient.