Peer review. Part 1: Attitudes to internal and external standards.

Two peer review groups of ten general practitioners each reviewed their management of headache and fatigue. Each group used internal standards which they had set for the review of one condition and external standards set by the other group for the other condition. Data for the review was collected from the general practitioners' case notes and presented to them. The following year their management was again reviewed. The attitudes of the general practitioners to the use of both internal and external standards in peer review were measured using written questionnaire. There was no statistically significant difference in attitude to the two different types of standards. The attitudes of the general practitioners to external standards from a variety of sources were also measured. External standards developed by other peer review groups of general practitioners were significantly more acceptable (p less than 0.05) than standards developed by hospital specialists or the Department of Health.