As a group, physicians strive for quality but often resist quality measurement. Cost, inconvenience, lack of time, mistrust of quality measures, and a fear of what assessment may find are all factors contributing to this resistance. However, quality, in both rich and poor counties, continues to be poor at worse and varied at best. If we are to improve the quality of our care, we need quality measurement to show us our weaknesses. A variety of tools are available to assess quality, which, when followed by the right policy interventions, can lead to improved care. Quality measurements are most effective when they are comparative, reflect the complexity of clinical practice, are not expected to be a panacea for spiraling costs, and are made available to our colleagues and our patients.