The power of any profession to regulate itself is a privilege given by the state through parliament and not a right.1 If society loses its confidence in the ability of the profession to exercise that right responsibly the possibility of alternative methods of regulation naturally arises. Recent high profile cases of serious professional misconduct or seriously deficient performance by doctors in the UK in recent months have dented that confidence somewhat, and sensationalised reporting in the media has done nothing to help the situation.2 It is encouraging, however, that in a recent public opinion poll conducted by MORI on behalf of the BMA, 87% of those polled said they would generally trust doctors to tell the truth. Only 7% of members of the public responding were dissatisfied with the way doctors do their jobs.3

A number of advantages accrue from a regulatory system that is controlled by the medical profession. Most people are reassured to know that doctors not only have contractual obligations to any employer but also professional obligations to live up to the standards of conduct, performance, and behaviour set by their peers, as these are invariably more demanding than any contractual ones. For self employed doctors, professional accountability is perhaps even more important. Doctors are also likely to have more confidence in a regulatory body for which they feel a degree of ownership than in external regulation; the teaching profession provides an example of the effect of externally imposed regulation on morale. Doctors are in a good position to define the standards that they expect of themselves and their colleagues, and these standards have been clearly expressed by the General Medical Council (GMC) in its document Good Medical Practice.4 There is, however, widespread recognition by the profession that strong non-medical input is …