SOLO OR PARTNERSHIP

Reassessment of the managed care environment and restructuring of our practice will be accomplished by transitional short-term actions while we institute our long-range plan. In the short term we must develop a ppropriate relationships with hospitals and medical groups that interr elate to our specialty, and develop a ''love our enemy'' philosophy. W e must establish operating organizational units that will be competiti ve. Reassessment of our own practice, our unique skills, our inadequac ies, our competition, and our performance through outcome studies is e ssential to retake positions weakened by loss of contract inclusion. L ong-term strategy must develop insurance coverage in conjunction with our patients in such a way that the middleman is eliminated and the pr ofit currently extracted by managed care is reinvested in patient care , research, and education. Whoever controls payment determines the qua lity of medicine and how it is delivered.