Cecal intubation rate (CIR) is an important metric for colonoscopy quality. Guidelines propose a minimum CIR of 90% for all indications, and 95% in screening procedures. In this issue, a study of three UK teaching hospitals demonstrated one-third of endoscopists inappropriately converted colonoscopies to flexible sigmoidoscopies, and several endoscopists only reached the 90% CIR benchmark because of these inappropriate conversions. Our professional societies and healthcare organizations must continue to work to improve the accurate assessment of colonoscopy quality in order to identify underperforming clinicians who should be provided with additional training for the benefit of their patients.