A recent article published in the Annals of Emergency Medicine focused on implementing a process to evaluate performance of older physicians. Some patient safety advocates are pressing for mandatory retirement age, an practice used in the aviation industry. Medicine has adopted other aviation industry practices such as checklists and team training in order to reduce errors and infections. A 2005 meta-analysis concluded the "longer a physician had been in practice, the worse his or her outcomes were likely to be and participation in continuing medical education and re-certification made no difference to the result." In response to this finding, the American Board of Internal Medicine published an editorial, "The profession cannot ignore this striking finding and its implications: Practice does not make perfect but it must be accompanied by ongoing active effort to maintain competence and quality of care." At present, there are no mandatory skills assessments for ongoing competency in any medical specialty.