There are tremendous changes taking place in health care. Yet I have found very little discussion of these changes and their impact on patients and physicians in any of the discussion groups. Physicians in certain parts of the country have had more experience with new systems of managed patient care (California and Florida), than physicians and patients elsewhere. At our medical school we are struggling with ways to be competitive in a managed care environment so that we can continue to train medical school students and residents. I would like to hear from anyone who knows of a location where these types of discussions are taking place, or who has had some experience with these issues. Please feel free to send e-mail or answer