Over the past two decades, pediatric practice has shifted focus from disease and infection to health promotion and risk reduction. Yet the tools to measure the effectiveness of pediatric care have not kept pace with this shift, according to the authors of this issue brief. This means that attempts to promote evidence-based care under the new health reform legislation may inadvertently neglect important aspects of pediatric care, including behavioral and developmental screening. The researchers propose a broad framework for evaluating pediatric practice that should be of value to clinicians as well as policymakers.