What is Quality Medicine?

There is one word in the value-based purchasing universe that seems so clear, but like art is in the eye of the beholder--Quality.  We all want and feel that we are entitled to quality medical care.  Measuring whether we are receiving (or delivering) quality medical care is not as simple as it sounds.  No one would quarrel with the concept that a primary element of quality is whether the the treatments given resulted in the patient's condition improving.  The real trick is measuring whether the financial and physical cost of the treatment to the patient or society is justified in a particular case.  How those determinations are made are the subject of intense research in government and private clinical settings.  An often over-looked aspect of quality medicine is (at least from the provider/professional side) the patient's perception of the care they received.  All of this points out that defining terms is a critical starting place in the development of a value-based purchasing system.