Progress is precisely that which rules and regulations did not foresee.
— Ludwig von Mises
THIS ISSUE OF JMR offers a substantial collection of articles on a variety of topics — all intended to help us make progress toward even more effective medical regulation. Our featured authors demonstrate for our readers a diverse array of policies and processes that have potential for optimizing medical regulators’ ongoing mission of public protection. We begin with the topic of electronic prescribing of controlled substances and providing feedback to individual prescribers regarding their habits (page 8). Overdoses on prescription-controlled substances continues to be a serious problem, and authors from Saskatchewan, Canada describe a system in which individual physicians receive personal structured prescribing feedback regarding their electronic prescribing habits in order to achieve quality improvement. We follow that with articles from authors in New Zealand and Australia, describing a major effort by Australian medical regulators to better understand the use of chaperones in physician sexual misconduct cases (page 17). Australian regulators concluded that the disadvantages of chaperones outweigh the advantages, and began a national movement away from their use as a result. Beginning on page 32, we have paired two articles on another topic of importance to regulators: cognitive screening of practicing physicians. Statistics show that our physician workforce is aging, and is beset by high levels of stress and burnout. Two approaches toward screening are offered — one that focuses on screening older physicians and another that suggests a lifelong model, with screening starting much sooner in a physician’s career. Next, we feature an interesting look at responses to an announcement from the Educational Commission for Foreign Medical Graduates (ECFMG) that, starting several years from now, physicians applying for ECFMG Certification must graduate from a medical school that meets its updated accreditation requirements (page 49). The authors compiled online input from those who will be impacted by this change to sense how it is being received. Finally, on page 57, we close with a summary of the FSMB's latest Census of Licensed Physicians in the United States, which is published by JMR every other year and which offers key insights into physician workforce trends. We hope you find value in this very full edition.