Many years before Medicare came to pass, the California Medical Association set out to develop a series of disciplinary mechanisms for the medical profession. Self-discipline among professional men and organizations is far more efficient than any sort of "discipline" that could possibly come out of a government bureau. Self-imposed review of medical practice and utilization of health facilities are necessary at all levels; the informed judgments of our peers can often be much harsher than the uninformed judgments from outside bodies.
There are four key areas of medical care in which the public expects help from the medical profession: cost, quality, availability, and scope of service. The California medical review programs have been developed carefully over the past few years to provide just that help. CMA has sought to serve as a catalyst in the state-wide development of these programs. One pioneering program, called "Guiding Principles for Physician-Hospital Relationships," was