In UK, it is standard practice for medical providers of any sort, including psychiatry clinics, to measure and assess their performance against set standards, such as those set by NICE or by Royal College of Psychiatrists. This seems to be an unusual practice in Japan, but in UK and I believe across a lot of the Anglophone world, it is not just common practice but considered to be an important part of clinical governance. (Clinical governance is the name given to the processes used to maintain high standards in health care.) Taking part in clinical governance activities, including an audit cycle, is a defined professional responsibility for all UK doctors. You can loose your license to practice if you don’t. Checking processes are followed and good outcomes achieved is, rightly, given a lot of emphasis. I am pleased to say that we are continuing this practice at American Clinic Tokyo and have audited the outcomes we are achieving for patients. The data will be published this month in an audit poster at Royal College of Psychiatrists International Congress held in Edinburgh. Once presented, I will publish it here.