There is some evidence that physician self-reporting is an efficient and effective way of collecting data on adverse incidents in health care. This study tested a simple prospective adverse incident audit, self-reported by physicians, on a general medical unit. A total of 158 reports were collected over a 6-month period covering a wide range of quality issues, including, but not limited to, safety issues. One-third of reported incidents occurred within 48 h of hospitalization. One-half of incidents were associated with harm or inconvenience to patients. Reported incidents fell into easily classifiable groups, and the data was used as a platform for a coordinated approach to quality improvement within the department. It is concluded that this technique is an easily implementable addition to the more traditional methods used for quality improvement within general medicine.