It has been said that a doctor or hospital can perform their services at a high level of quality, but if the care is not suited to the health problem, then it is inappropriate and can be extremely harmful. One example is that a surgeon might amputate a leg perfectly following all correct protocols, but if he cuts off the wrong leg, then undoubtedly there is a serious problem.

Studying the appropriateness of care is a difficult and challenging endeavor as different doctors and hospitals may disagree on what constitutes "appropriate" in any given patient situation. However, such studies are essential in determining whether a particular treatment plan is likely to result in a positive outcome or unnecessary and wasteful care that causes healthcare costs to continue to escalate with no corresponding benefit.

To this end, CHCC is working with Dr. Adams Dudley of the University of California at San Francisco to support the California Appropriateness Project ("CAP") to develop metrics with which to evaluate the appropriateness of physician services. Working with physician organizations, professional societies of medical specialists and selected commercial health plans, the California Appropriateness Project aims to build an industry-wide, multi-stakeholder physician evaluation system that will identify and report wide, medically unwarranted differences in clinical practices and engage providers, patients and consumers to improve the use of evidence-based medicine.