• Healthcare quality
• leadership
• medical education

A century ago this year, the Flexner Report of 1910 described the largely deplorable state of American medical education.1 The Rockefeller Foundation spent decades and a lot of money improving these schools.2 Those schools that did not meet the new standards closed their doors. By 1950 the Foundation leadership asked themselves if their successful efforts to improve education had, by then, actually changed the real practice of medicine for average Americans. It was decided that Osler Peterson was the person to go and see. Osler Peterson MD was, at the time, on the Rockefeller Foundation staff. He was seconded to the University of North Carolina where he undertook to watch the actual practice of medical care provided by a sample of 102 primary care doctors in that state in order to judge the quality of care they were providing. He and his colleagues reported their observations in a special supplement in 1956, of the Journal of Medical Education.3 As a result, this mild, curious, scholarly man made a lot of enemies among these practitioners. However, in later years, and in spite of this experience, he was willing to take on organised medicine over national health insurance and the American surgical establishment.