Why on earth do surgeons need quality assurance?

The article discusses the ways in which surgeons should respond to the growing external and internal pressures for ensuring the quality and appropriateness of surgical treatment. Quality Assurance is defined. Its development in the USA is described and it is debated whether or not a similar system should be introduced into the United Kingdom. The reasons for initiating a system of quality assurance into one health district and the experience so far gained is reported. The problems of quality assurance and some of the solutions are discussed.