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=== Performance and professionalism supervision === The issue of [[medical error]]s, drug abuse, and other issues in physician professional behavior received significant attention across the world,<ref>{{cite journal |author=Lim MK |title=Quest for quality care and patient safety: the case of Singapore |journal=Qual Saf Health Care |volume=13 |issue=1 |pages=71β5 |date=February 2004 |pmid=14757804 |pmc=1758053 |doi=10.1136/qshc.2002.004994 }}</ref> in particular following a critical 2000 report<ref>Committee on Quality of Health Care in America, Institute of Medicine. (2000). To Err is Human: Building A Safer Health System. ''National Academies Press''. [http://www.nap.edu/catalog.php?record_id=9728#toc Free full-text] {{Webarchive|url=https://web.archive.org/web/20141112150724/http://www.nap.edu/catalog.php?record_id=9728#toc |date=12 November 2014 }}.</ref> which "arguably launched" the patient-safety movement.<ref>{{cite journal |author=Wachter RM |title=Patient safety at ten: unmistakable progress, troubling gaps |journal=Health Aff (Millwood) |volume=29 |issue=1 |pages=165β73 |year=2010 |pmid=19952010 |doi=10.1377/hlthaff.2009.0785 }}</ref> In the US, as of 2006 there were few organizations that systematically monitored performance. In the US, only the [[Department of Veterans Affairs]] randomly drug tests physicians, in contrast to drug testing practices for other professions that have a major impact on public welfare. Licensing boards at the US state-level depend upon continuing education to maintain competence.<ref>{{cite journal |author=Leape LL|author2=Fromson JA |title=Problem doctors: is there a system-level solution? |journal=Ann. Intern. Med. |volume=144 |issue=2 |pages=107β15 |date=January 2006 |pmid=16418410 |doi= 10.7326/0003-4819-144-2-200601170-00008|doi-access=free }}</ref> Through the utilization of the [[National Practitioner Data Bank]], [[Federation of State Medical Boards]]' disciplinary report, and American Medical Association Physician Profile Service, the 67 State Medical Boards continually self-report any adverse/disciplinary actions taken against a licensed physician in order that the other Medical Boards in which the physician holds or is applying for a medical license will be properly notified so that corrective, reciprocal action can be taken against the offending physician.<ref>{{cite web |url=http://www.medlicense.com/ |title=Medical Board Licensing Service for Physicians seeking an Expedited Medical License with any of the 50 State Medical Boards |publisher=MedLicense.com |access-date=19 September 2011 |archive-date=2 April 2021 |archive-url=https://web.archive.org/web/20210402211024/https://medlicense.com/ |url-status=live }}</ref> In Europe, as of 2009 the health systems are governed according to various national laws, and can also vary according to regional differences similar to the United States.<ref>{{cite journal |author=SuΓ±ol R|author2=Garel P|author3=Jacquerye A |title=Cross-border care and healthcare quality improvement in Europe: the MARQuIS research project |journal=Qual Saf Health Care |volume=18 Suppl 1 |pages=i3β7 |date=February 2009 |issue=Suppl_1 |pmid=19188459 |pmc=2629851 |doi=10.1136/qshc.2008.029678 }}</ref>
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