Although generalizable solutions are not yet within our reach, the studies in this issue clearly document that physicians must hold themselves to a higher standard than simply maintaining the status quo. The success of the VHA demonstrates that continued managerial momentum can lead to sustained improvement even in disadvantaged populations. We, therefore, offer a modest but achievable proposal for every health care professional, every practice, and every private and public health care system. First, review your own data and processes of care for diabetes. Second, use the principles of evidence-based medicine to identify the highest-priority goals and treatment strategies (20). Third, develop actionable plans to increase the proportion of clinical encounters in which clinicians take appropriate action. Fourth, systematically track progress toward achieving treatment goals. Fifth, give feedback to those who are making patient care decisions (9). We must recognize the deadly consequences of clinical inertia and commit ourselves to the task of overcoming it in our own practices. If we succeed, we will improve the prospect of healthier lives for tens of millions of Americans.