On being scientific about organising care

Good care poorly delivered is diminished. Doctors, trained primarily in tending for individual patients, might like to think that care can be organised by a few “administrators” without anybody needing to think too hard. But it can't. Organisation is often difficult, and, as this issue of the journal illustrates, it needs to be based on evidence.

For starters, should patients be operated on by surgeons who do more than a certain number of operations a year? It seems likely that surgeons who do more operations may be better than …