Medical audit usually implies evaluation of medical practice in order to control whether certain standards are complied with. Research on decision making has disclosed, however, that standards for clinical problem solving are not always easy to establish. It has been difficult to influence doctors to adhere to standards defined by experts. We therefore propose that medical audit should focus more on education than on control. If standards are to be used, the doctors participating in medical audit projects should also help to define the standards. We suggest the following procedure for medical audit projects: observe practice--reflect on it--identify changes--formulate standards--implement changes--evaluate changes--give feedback to the group about the outcome. Standards defined by experts working remote from medical practice, must be replaced by standards based on practical knowledge acquired by doctors with common experience.