CMA recommends that every medical staff have a system for proctoring new staff members during their initial period of provisional staff membership and existing members requesting additional privileges. Letters of reference, evidence of training, even board certifications, are no substitute for first-hand observation. It is sometimes argued that a physician from the community is "known" To many members of the staff. Unfortunately, it is just such casual professional acquaintance which may lead to a less than objective evaluation of the individual's actual clinical competence. a well established system of proctoring is the staff's own safeguard against compromising standards of quality in patient care. See CMA Guidelines for Medical Staff Proctoring, a copy of which is at the end of this document. CMA policy, as well as that reflected in CMA's Model Medical Staff Bylaws, set forth the qualifications of the proctor and respective responsibilities of the parties. However, CMA receives legal questions concerning proctoring as follows in this document.