Personal contact with a hospital and patients who have received treatment there offer the best opportunity to assess its quality. A certification merely shows that a quality management system has been implemented, but says nothing about the quality of the actual outcomes achieved. Quality reports aid the family doctor to make an estimate of departments with which he has not so far cooperated. Objective information regarding the quality of outcomes are considerably more difficult to obtain. There appears to be a correlation between large numbers of operations and the quality of the surgery. In this area, the physician is dependent on voluntary publication of performance reports.