The hope is not to see structure and process measures disappear. Instead, the hope is to have structure and process tied to outcome, "outcome-based structure" (e.g., in medicine, numbers of nurses per patients needed to save lives on hospital wards, since mortality has been tied to staffing numbers) and "outcome-based process" (e.g., the proportion of patients with unremitting psychotic symptoms who were given a trial of clozapine, since the percentage of such patients remitting has been tied to clozapine trials). Outcome-based structure and outcome-based process measures would replace the structure and process measures of the past that were based on only intuition or a theory. This hope has many dangers of oversimplification. The empirical reach in psychiatry has its limits, especially in a nonresearch setting, where terrible outcomes can occur in high-quality programs and terrific outcomes can occur in the worst of programs. To answer many outcome questions for common clinical settings requires a large, often unattainable, number of subjects.