Concerned citizens have responded to the health care crisis by develop
ing the health decisions movement. American Health Decisions, a nation
al consortium of 21 state organizations, leads a grass roots discussio
n network of community meetings committed to education and consensus o
n the ethical, technologic, legal, and economic issues (the tough issu
es) of health policy. The movement (with its stages of development, st
ructure, process, and accomplishments) is described, and potential rol
es for physician cooperation and participation in forging functional,
community-based health policy are delineated.