The chief medical officer has given us 44 recommendations to ponder in his long awaited consultation document.1 If we were scoring him on 44 questions, he might attain an enviable mark of 95%—yet still have two or three wrong answers in the report. It would be a mistake for the medical profession to dwell on the recommendations we don't like while missing the good within it. Certainly the Royal College of Physicians (RCP) welcomes much of the report. It has consulted widely, and most of its members are not stuck on the question of “if” in relation to the revalidation of their competence to practice and have moved on to those of “how” and “when.”

But then, why did 750 doctors and patients sign a letter to the Times on 17 October, dismissing the report as an attempt to “deprofessionalise” doctors? Medical professionalism is a topic the RCP has looked at hard in the past year or so, in an attempt to update it in the context of changing values both in doctors and wider society. …