Quality improvement by peer review in primary care: a practical guide.

The reluctance of people to have their work evaluated is closely linked with their reluctance to comment on, or to complain about the behaviour of others. Most people 'live and let live'. This attitude, we admit, is not only understandable: it is invaluable. Social life depends on it. Who should throw the first stone? Who indeed can really distinguish between an honest mistake and culpable negligence? This is why we believe that efforts to improve performance must come from a desire for self-improvement, a desire based on an essentially ethical insight. Audit must not be part of a disciplinary instrument; it must be a tool for learning by feedback.'