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In the past seven years the Service for Prevention and Safety in Workplaces of the Health Local Agency of Rome C set out some activities towards the occupational physicians (so-called "competent physicians") of three different kinds: control and surveillance, institutional activities on demand and activities for quality improvement. In the first ambit we conducted some investigations on the procedures of the workers' medical surveillance and the role of competent physicians in the risk evaluation inside three different intervention projects (monitoring the enforcement of the D.Lgs. 626/94; intervention on the chemical risk, intervention in the car repair shops). In the second ambit we analysed 92 notifications of occupational diseases and we dealt with 27 appeals against the judgement of the fitness to work. In the third ambit we made 19 meetings on various subjects: correct procedures in medical surveillance, quality in diagnostic examinations, the enforcement of new regulations. We report the results of these interventions which let us identify the most common criticalities in the activity of the competent physicians, but also to face them with a new approach based more on peer review instead of control and surveillance.