Audit: an annual assessment of the work and performance of a surgical firm in a regional teaching hospital.

Abstract

The assessment of the results of treatment has for long been one of the responsibilities of the medical profession. Prospective and retrospective surveys have formed the basis of original and review articles in the medical press, and of lectures and seminars. Postgraduate education has been well served by these traditional methods, which have often led the individual doctor to change and so improve his or her techniques in diagnosis and treatment. The scene, however, is changing. The cost of medical treat ment required to provide a comprehensive health service has, for various reasons, outstripped the resources available from the State. As a consequence the allocation and reallocation of finances and personnel have become matters of great importance to administrators, doctors, and politicians. A second change has been in the attitude of the patient, who has become more knowledgeable about health, and if, sometimes, higher expecta tions of hospital or medical care are unrealised may more often turn to some form of official complaint, or even litigation. Thirdly, the profession itself is changing. The number of graduates is increasing, and their attitude is naturally influenced by the changes in the medical curriculum over the past 20 years: overall there has been a reduction in the emphasis on acute hospital medical and surgical care, which has often been a dominant factor in health care planning in the past. It would be surprising if demands for the more accurate assessment of clinical performance, related especially to cost, had not been heard. It would be equally surprising if the pro fession had not responded. Demands there are?for example,