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Are 'Indexes' an Index of Physician Performance?

Robert B. Howe, MD
Arch Intern Med. 1985;145(1):46. doi:10.1001/archinte.1985.00360010066007.
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In this issue of the Archives, Hansen and associates1 present data from a chart audit reflecting physician behavior in the interpretation of RBC indexes. The authors begin with the fact that patients having low mean RBC volumes and high RBC counts relative to those volumes will commonly be found to have thalassemic syndromes if properly examined. Physicians working in areas with large populations of patients from racial stock originating in the Mediterranean basin and large populations of black patients have had to concern themselves with this problem for years. Now the influx of refugees from Southeast Asia increases the numbers of persons at risk and distributes the problem to new regions of this country. Additionally, the need for cost control in medical care increases the incentive to make appropriate clinical decisions based on relatively inexpensive tests such as RBC indexes.

Since RBC indexes are routinely provided as part of


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