The article discusses the challenges of using outcomes as measures of quality in primary care, particularly in the context of diabetes management. It argues that outcomes are influenced by factors beyond medical care, making them less reliable for comparing quality. Process measures, which are more under the control of doctors and practices, are less affected by case mix differences. Examples include body mass index measurements and flu vaccination rates, which were lower in women, poor people, and ethnic minorities, suggesting poorer quality of care for these groups. The author suggests that financial incentives in the new general practitioner contract may help reduce disparities, but adjusting payments based on deprivation could be complex and lead to disputes. The article emphasizes the need for ongoing evaluation and policy changes to improve quality, efficiency, and equity in healthcare. In addition, the article includes corrections to previous errors in the journal, such as a typo in a measurement and a URL mistake in a support group link. It also discusses multimedia learning, noting that early attempts were cluttered and ineffective, but modern approaches are more purposeful and accessible. The BMJ Learning site provides multimedia content, including a module on psoriasis, which uses images to train diagnostic skills and update management practices. The article highlights the importance of adapting multimedia learning to be effective and user-friendly.The article discusses the challenges of using outcomes as measures of quality in primary care, particularly in the context of diabetes management. It argues that outcomes are influenced by factors beyond medical care, making them less reliable for comparing quality. Process measures, which are more under the control of doctors and practices, are less affected by case mix differences. Examples include body mass index measurements and flu vaccination rates, which were lower in women, poor people, and ethnic minorities, suggesting poorer quality of care for these groups. The author suggests that financial incentives in the new general practitioner contract may help reduce disparities, but adjusting payments based on deprivation could be complex and lead to disputes. The article emphasizes the need for ongoing evaluation and policy changes to improve quality, efficiency, and equity in healthcare. In addition, the article includes corrections to previous errors in the journal, such as a typo in a measurement and a URL mistake in a support group link. It also discusses multimedia learning, noting that early attempts were cluttered and ineffective, but modern approaches are more purposeful and accessible. The BMJ Learning site provides multimedia content, including a module on psoriasis, which uses images to train diagnostic skills and update management practices. The article highlights the importance of adapting multimedia learning to be effective and user-friendly.