It is now possible to measure the quality of medical care accurately, and when systematic measurement of health care system performance is undertaken, substantial deficits in quality of care are found. Although there are some strategies for continuing medical education (CME) that can change behavior and improve quality, much of current CME relies on techniques known to be ineffective. Public release of information on performance in the form of report cards is becoming more common, and will put increasing pressure on payers and providers to improve quality of care. Unless CME can show it has a central role in quality assurance, it faces being replaced by other models of performance improvement. However, the performance measurement revolution also provides an opportunity for CME to gain recognition and support. This will require providers of CME to work more closely with those who measure performance. Providers of CME should focus on areas of practice that have undergone performance measurement. They should also work with those who are developing report cards, so that the timing and content of education are linked to the content and release of report cards. If linked together rationally, performance measurement and continuing education can become the basis for maintaining and improving quality of care.