Long before many of us can remember, there were only two people sitting in the chiropractic treatment room – the patient and the doctor. Gradually, the state licensing boards starting showing up. They were joined by the insurance industry. Then health policy makers like Medicare and Medicaid. Followed by more members of the insurance industry. Then scientists made an appearance, talking about evidence-based clinical practice. Now this already very crowded room may become even more crowded if we open the door to the ever-loudly-knocking performance measurers. We have had time to get at least somewhat used to the state and national boards, insurers, policy makers and even the scientists, to some extent. But what is performance measurement and how might it be beneficial to the practice of chiropractic?