Managed care in California. Daunting new realities for dermatology and academic medicine

Managed care is the predominant method of health care delivery in Sacramento, Calif; the effect on our academic medical center is profound. The lessons we are learning in the development of a university-based health care network have applicability to dermatology. The future of dermatology demands that all practicing dermatologists have an understanding of the challenges and that they participate in the design of appropriate cost-effective strategies for the future.