The essence of professionalism is self-governance. Central to self-governance is self-criticism.1 The public trusts medical professionals to be honest with themselves, with each other, and with them. Honesty is exemplified in quality assurance activities within organizations. These are based on the recognition of problem areas, identification of errors when they occur, and institution of corrective actions. The responsible action taken by the faculty and staff at the Beth Israel Hospital in Boston, Mass, and reported elsewhere in this issue in the article by Bedell and colleagues2 should be lauded and considered a model for other institutions interested in ensuring quality.
The editors of The Journal have chosen to publish a number of challenging articles of this nature. For example, the April 24, 1991, JAMA included two research papers on the frequency of substance abuse among resident physicians and medical students3,4 and a remarkably candid Special Communication, "Do