Recertification and peer review in the United States.

I AM delighted to respond to the Honorary Editor's invitation to write for the Journal of the Royal College ofGeneral Practitioners about some ofthe major issues in American medicine. They are physician-centred issues, but they have arisen from concerns expressed by the public and the government. They are: the evaluation of the necessity and the quality of medical care, and the evaluation of the knowledge and competence of the practising physician. As medical editor of American Family Physician (its title was GP until three years ago), the official publication of the American Academy of Family Physicians (AAFP), I have long been actively concerned with the continuing education ofgeneral practitioners. I enjoy greatly helping to further the objectives of the American Association of Family Physicians which has, since its foundation in 1947, led American medicine in requiring continuing educational efforts as a condition of membership.