Incorporating peer review into routine clinical work: a practical example.

We describe a simple quality assurance (QA) exercise that compared the practices of two physicians providing geriatric consultations at a University teaching hospital. Two hundred consecutive referrals were randomly allocated to either physician. Although the patients referred had similar characteristics, their problems were managed differently. This led to an evaluation of work practices and identification of problems to which solutions were found. As the study was incorporated into routine clinical work, its cost in terms of resources and manpower was minimal. Such simple practical QA exercises should be used more extensively to enhance the practice of medicine.