AS MANAGED CARE organizations (MCOs) become commonplace in the field of medicine, physicians not only in patient practice but also in medical education, clinical research, and public health are grappling with the challenge they present. The task is hardly started, it will not be easy, and it will not be accomplished overnight. This is the overall message from several forums that have addressed the impact of managed care on the future of medical practice.
Among these aspects were the following:
• Education: Teaching hospitals are developing ways to instruct students in the skills they will need to practice in a managed care environment.
• Clinical research: The advent of managed care and the national emphasis on reducing the cost of health care is forcing reevaluation of the traditional means of funding clinical research in part from fees charged for patient care.
• Public health: As health departments find their