State licensing boards and the legal justice system protect the medical profession and the public from patently bad doctors. But, short of egregious misconduct or malpractice, how do we hold physicians accountable for, say, rudeness or encouraging patients to undergo optional surgery? The July issue tackles this question by investigating the principles and professional initiatives—proposed and in place—to assess physicians’ day-to-day competence and judgment. These range from full informed consent and second opinions to use of evidence-based practices, pay-for-performance and retrospective audits of charts. The op-ed writer asks, “Is it fair to expect doctors to practice what they preach?”