Like it or not, we all live in a time where performance outcomes are readily measured. Those of us who have been practicing for the last 10 years are familiar with early versions of practice metrics, such as SCIP (the Joint Commission’s Surgical Care Improvement Project) and others. Many SCIP items were designed to decrease the incidence of hospital-acquired infections. For instance, one of the most common SCIP indices is that of antibiotic timing prior to surgical incision. Others of these SCIP measures are proper hair removal in the area of an incision, appropriate antibiotic selection, appropriate discontinuation of antibiotics, timely postoperative removal of urinary catheters and, perhaps, perioperative control of glucose levels in cardiac surgery patients. Initially, these measures were put in place to assist an institution in determining its own production quality, but they have morphed into actions that affect payment for services rendered.