“…Stapleton (118) reported a higher level of performance by staff physicians caring for patients in a teaching service than when the same physicians cared for comparable patients in a nonteaching service of the same hospital. De Dombal et al (93) observed that surgeons, required as part of a study to provide critical data upon which they based their diagnosis and decision to operate, substantially reduced the incidence of ruptured appendices and of non indicated operations during the study. After the study ended, performance of the same surgeons promptly reverted toward previous less satisfactory levels.…”