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"Medicare had created a national database showing how long it took hospitals across the country to get heart patients' arteries opened. It was a bell curve year after year, and the times were not getting any better. But there were a few hospitals at the tail end of the curve that year after year were treating people in an hour or so. Dr. Krumholz and his colleagues visited the 11 best performing hospitals. They were not famous institutions or major medical centers, said Elizabeth Bradley, a professor of public health at Yale and a leader in the project. Some were community hospitals; others were far from major population centers. The investigators recorded every detail of how the hospitals got things done and ended up with a short list of what the stellar performers had in common - procedures Lourdes later adopted."

revisions in the D.S.M… won't alter clinical practice much… because psychiatrists tend to treat according to symptoms. So why the fuss over D.S.M.-5? Because of the unwarranted clout that its diagnoses carry with the rest of society: They are the passports to insurance coverage, the keys to special educational and behavioral services in school and the tickets to disability benefits.