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Myron Melamed, MD
JAMA. 1976;235(20):2190. doi:10.1001/jama.1976.03260460014006.
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To the Editor.—  I read the article by Dr Brewer entitled "Guidelines for Recertification" (235:725, 1976) with a sense of scientific indignation.

  1. Nobody has ever established that reexamination by any method has any correlation with quality of patient care.

  2. There is also significant question as to whether routine postgraduate study to obtain a certain number of "points" has any value in this regard.

  3. The logistics for routine postgraduate education are mind-boggling when one considers the cost involved in physician time and expenses for a few hundred thousand doctors.

  4. One can seriously question who should be the examiner and the examinee when physicians of considerable experience are involved.

  5. It would seem that a medical audit system for physicians in hospital practice would determine the presence or absence of quality patient care when physicians are judged by their peers of departmental committees. This could be done in


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