Destructive goal pursuit (DGP) is the situation in which goal setting becomes dysfunctional, leading to impaired performance. This paper considers the 4-h target against the model of DGP and finds many similarities. It does not attempt to provide a critique of the model, nor does it seek to review all the effects of the 4-h target. The need for multiple goals, for all domains of quality to be addressed in these, and for a focus on effective team working and team learning are emphasised. Targets, in a way analogous to drugs or other ‘therapeutic’ interventions, have the potential to cause adverse effects as well as positive ones. A greater understanding will help ensure their overall impact is as beneficial as positive.