A recent article in the British Medical Journal raised important questions about professional transparency, the collection and use of outcome data and the respective roles of professional societies, commissioners of care, regulators and politicians.1 Professional societies have traditionally been viewed both internally and externally as existing largely for the benefit of their members in providing a forum for education and scientific exchange as well as focus for interaction with other professional organisations and with various regulatory bodies.2 This perception has evolved with the increasing involvement of large international societies in the development of guidelines for the delivery of cardiology care. The mission statement of the European Society of Cardiology is to reduce the burden of cardiovascular disease in Europe, that of the American College of Cardiology to transform cardiovascular care and improve heart health and that of the British Cardiovascular Society to promote excellence in cardiovascular care. These are sweeping and ambitious aims and extend much further than the provision of education and the writing of practice guidelines, essential as these activities are. Regulators are becoming more interested in the continuing competence of medical staff. In the UK medical revalidation is just beginning with the explicit aim of assuring patients and the public, employers and other healthcare professionals that licensed doctors are up to date and fit to practice.3 Revalidation is about defining acceptable practice, not excellence, and the expectation is that the vast majority of doctors will pass muster. In the US physicians must complete Maintenance of Competence (MOC) over a 10-year cycle including self-evaluation of medical knowledge and practice performance and an exam.4 Modern medical professionalism extends beyond competence and mandates that doctors keep the needs of patients paramount and view their service through their patients’ eyes. All patients deserve good doctors but what …