Considering the discrepancy between scientific knowledge and definite behaviour during consultation ("performance gap"), acceptance, proceedings and case oriented work in quality circles/peer review groups are described. 79% of 138 general practitioners declared that working in quality circles should base on cases from daily practice. Exchange of experiences and the expectation to get help for solving specific problems in the daily practice are the most important motives for participating in quality circles. For one circle as an example, the process of topic and case oriented work on the basis of objective documents from the practices of the participants and the following case oriented development of guidelines are described. Finally, the implicit chances of case oriented work in quality circles are shown with respect to existing experiences.