Surgeons, high risk interventions and the birth of the Star Chamber

In the past, surgeons and doctors carried out their work with little measurement of their clinical outcomes and with no external scrutiny of such outcomes. This era is now finished. In the last century, medicine has progressed from haphazard treatments given with little scientific grounding to rigorous evidence-based treatment. In the last twenty years, we have seen a new development: the evaluation and monitoring of how well such treatment is administered or, in other words, the quality of the delivery of medical care.