To the Editor: The CareTrack study1 has produced considerable debate that has mostly focused on its aggregated findings about compliance with appropriate health care delivery. There needs to be much wider discussion, not about the aggregate figure, but about the variation, such as the 39 health care providers for whom compliance varied between 32% and 86%. Such unwarranted variation in health care has been identified elsewhere through proactive initiatives.2,3
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I have acted as a consultant, written commissioned articles and presented as a paid speaker internationally in primary care quality improvement.