The slow progress in health care quality improvement and patient safety in America can be attributed, in part, to the challenge of physician engagement. As multidisciplinary patient-centered care becomes the standard, it is essential to integrate physicians into this process. To this end, the UMass Memorial Medical Center redesigned its Physician Quality Officer (PQO) program in 2007. The PQOs of the UMass Memorial Medical Center, who are all practicing clinicians, are fully compensated for their time and effort, trained in safety science, and teamed with other members of the department of quality and patient safety. Over the first year of the new program, the PQOs have successfully led major hospital initiatives in areas such as surgical care improvement, critical values reporting, and medication reconciliation. In this article, the authors describe the challenges and insights in the development and implementation of this new program.