In this article, the Good Stewardship Working Group reports the results of an effort by the National Physicians Alliance to develop a list of the “Top 5” activities in family medicine, internal medicine, and pediatrics where the quality of care could be improved, generally by providing less health care. The editors of the Archives of Internal Medicine applaud this effort and plan to publish a series of articles focused on specific top 5 activities, providing evidence to document that the risks and costs of these activities outweigh the benefits. We look forward to studies documenting the impact of the top 5 list on the quality of health care.