TQM has a place in the medical practice. While it will require that the practice deal with the many barriers to change in the practice, the results can be significant. Increased patient satisfaction, lower costs, improved quality of work life, and increased productivity can enhance the working of a practice at a time when there are significant pressures on the practice and physicians. TQM may indeed be a way for a practice to take more control of this changing environment rather than being controlled by it.