Clinical microbiologists are continually challenged to integrate the concepts of cost-effectiveness and clinical relevance into their daily practice. However, many microbiologists find this a daunting task and may be unsure where to begin. Two of the most difficult specimens to deal with in the microbiology laboratory are respiratory and wound specimens. This is because they contain resident flora mixed in with the pathogens causing the infections. It can often be difficult to determine what might be a potential pathogen versus the normal resident flora. This lecture will review two systematic approaches to help the bacteriologist to determine which organisms might be potential pathogens in these culture types. The Q-score and the Q234 systems will both be presented with examples of how each can be used, how they are similar and how they differ. At the conclusion of the presentation the audience should be able to decide which method would fit into their workflow for the work up of respiratory and wound specimens and provide consistent and relevant results to clinicians for care of their patients.