On the basis of data from naturalistic studies it is shown that the actual outcome in schizophrenia is by far not as good as it could be. Thus, for example, the relapse rates of schizophrenic patients lie 200% above the value that could actually be achieved according to today's state of knowledge. This results in extra costs of several billion dollars each year. The causes of this great discrepancy between possible and actual outcome are hardly known, since psychiatric researchers have previously not been very interested in the outcome of normal care patients. But patients, carers and fund holders expect that psychiatrists should rapidly close the gap between the actual and the possible outcome. They will succeed only if psychiatric researchers become more interested in the normal care situation, perform more naturalistic studies, more compliance research, and more studies into medical decision making.