In June 2003, Annals of Internal Medicine began a section called Improving Patient Care. In the subsequent 126 issues to date, we'e published 77 Improving Patient Care articles: 9 randomized trials, 35 observational studies, 19 essays, 5 systematic reviews, and 9 articles from the Quality Grand Rounds series. Some of these articles were about the effect of interventions to improve quality of care (for example, reminders about an appointment for colonoscopy). Some of these studies used preexisting data, and some were planned, controlled experiments. In the review and editing process, we treated these interventional studies much as we treat a comparison of 2 biological interventions (for example, comparing different forms of insulin): In other words, we didn't pay much heed to the unique attributes of the intervention called quality improvement and didn't check to see whether the authors discussed them in the article. If we had, perhaps workers in the field would have learned more from Improving Patient Care articles.