What should health care be trying to accomplish? This question becomes increasingly important as research advances, the population ages, and financial pressures intensify. Simple measures for which 100% is the target cannot define performance for the complex work of health care. Quality does not mean the elimination of death or perfect compliance with guidelines. Efficiency does not mean the elimination of all spending or even 100% elimination of all wasteful spending. And compassion for patients does not mean the elimination of all pain.