Spirometry is a simple test, but experience has shown that many technical pitfalls can invalidate measurement of lung function. Failure to identify testing technicians and/or facilities that routinely administer tests incorrectly can be a costly mistake. Dr. McKay has conducted hundreds of external Pulmonary Function Testing (PFT) Quality Assurance reviews for testing facilities worldwide. These reviews provide comprehensive feedback to the PFT owner as well as to the testing technician. In many cases the test operator assumes no one will be evaluating test quality, so why bother. In other cases, the owner may not realize their tests do not meet accepted standards. The cost for the Quality Assurance analysis is dependent on the number of tests reviewed and the type of report desired. Generally a minimum of 10 to 20 PFT reports (ie, subjects) is suggested to evaluate the site as a whole. This is called a "Site" report. If the testing program has multiple testing technicians, it may be desirable to evaluate each testing technician separately. When a "Site & Technician" report is requested, individual technician results are coded to maintain confidentiality. Each technician receives results for the program as a whole in addition to their own results. The original PFT's and report(s) are returned to a single contact person for internal distribution. Why conduct an external QA review? We have found that programs participating in the QA review process show an improvement in test quality simply based upon the fact that an outside review process is in place. The QA reports helps to identify program strengths and weaknesses, which can then be addressed. Standard setting organizations such as the ATS, ERS, ACOEM and others recommend quality assurance programs. Dr. McKay's experience can help your organization achieve this goal.