Publishers' information discovery and access platforms use metadata to provide faceted displays, links to author profiles, and other enticing enhancements. I find it ironic that these competing products are essentially catalogs, craftily biased to promote their own brands of content. Not only do our library budgets pay and repay for this content, but we also fund the duplicative system development—which competes directly with our own efforts to provide integrated interfaces to our emerging digital libraries. This puts libraries at risk of diminished “market position” vis-a-vis such private-sector solutions, which benefit from the fragmentation that we strive to overcome. Libraries are brand agnostic. I consider this impartiality, as well as our ethics and quality orientation, to be of strategic value. However, the declining popularity of library catalogs and interfaces suggests that we may not be as “user oriented” as we like to think. The fundamental problems relate to scope and content policy: arbitrary coverage of some resources or formats and not others; a general versus topical focus; awkward federation of cataloging, indexing, and full text; and notably thousands of separate efforts to do the same thing. In addition, metadata formats, which could be instrumental in addressing these problems, have tended toward the extremes—from the overly simple Dublin Core to the overly complex MARC and resource description framework (RDF) (discussed later). In both regards and due to the similarity of our user populations, I believe that medical librarians can capitalize on our shared values and reclaim the high ground in regard to information organization and access by cooperatively tailoring interfaces that actually fit our users' needs. Separately, we risk being outsmarted at our own game. To appreciate the gist of my thinking, some exploration of current metadata issues is in order. Two aspects of metadata—identities and relationships—are central to initiatives both within and outside the library profession. They parallel the familiar cross-references—“see,” identifying a preferred synonym, and “see also,” indicating a relationship—recorded in authority records and controlled vocabularies. Answers to the questions below explore how establishing identities is a fundamental prerequisite for building reliable relationships between specific instances of various kinds of metadata. Following these basics, I delve into current controversies involving relationships—both as a basis for organizing content on the web and for improving cataloging infrastructure—because these have become so entangled. Then, I discuss keywords, often raised as an alternative to metadata, before returning to my suggestion that medical libraries would fare better—together.