The issue of medical errors, drug abuse, and other issues in physician professional behavior received significant attention across the world,[41] in particular following a critical 2000 report[42] which "arguably launched" the patient-safety movement.[43] In the US, as of 2006 there were few organizations that systematically monitored performance. In the US, only the Department of Veterans Affairs randomly drug tests physicians, in contrast to drug testing practices for other professions that have a major impact on public welfare. Licensing boards at the US state-level depend upon continuing education to maintain competence.[44] Through the utilization of the National Practitioner Data Bank, Federation of State Medical Boards' disciplinary report, and American Medical Association Physician Profile Service, the 67 State Medical Boards continually self-report any adverse/disciplinary actions taken against a licensed physician in order that the other Medical Boards in which the physician holds or is applying for a medical license will be properly notified so that corrective, reciprocal action can be taken against the offending physician.[45] In Europe, as of 2009 the health systems are governed according to various national laws, and can also vary according to regional differences similar to the United States.[46]