The role of medical associations in quality assurance

The European governments have decided to install quality assurance programmes in their health care systems by 1990. Quality is being defined as: "safe, effective, efficient, acceptable and appropriate care rendered by competent providers on the basis of efficacious technology". A wide range of methodologies is available for the assessment of each or several of the different dimensions of quality. Implementing these methods can be the role of either voluntary organizations or of mandatory ones. Medical associations could assume a leadership role in the field of quality assurance and contribute to the development of data-poor assessment systems and to the strengthening of existing information and management systems. The prevailing concept of clinical autonomy and its use in the practice of medicine should be revised.