High-profile cases of inappropriate stenting have shocked all and stirred passions among patients and the public, media, medical professionals, and legislators, causing the integrity of interventional cardiology at large to come under fire. How widespread is the inappropriate use of percutaneous coronary intervention? What constitutes appropriate care? Have the 2009 Appropriateness Criteria been widely adopted by cardiologists? Is there a way to "police" uptake of the guidelines? Our panel of experts gathered during the recent American College of Cardiology 2011 Scientific Sessions to discuss what constitutes appropriateness, how it's measured, and how it should be enforced. They debate what interventional cardiology is doing to standardize appropriate care, what measures should be adopted to ensure that outliers are reined in, and, in an era of prolonged economic woes, ask how costs can be contained while delivering the best, most appropriate patient care.