Many doctors in the United States are failing to conform to professional guidelines. A survey sponsored by the US Institute of Medicine found that doctors often fail to conform to accepted norms in areas of self regulation, managing conflicts of interest, and ordering of unnecessary tests.

Moreover, although most respondents thought they should report colleagues who were not competent, almost a half said that in the past three years they had known of a doctor who was “impaired or incompetent” but had failed to report the doctor to a relevant authority (Annals of Internal Medicine 2007;147:795-802).

The survey of …