In the arena of managed care and large delivery systems, professional
associations find it increasingly difficult to influence the environme
nts in which their members practice. Physician executives appear likel
y to play key roles in the response of medicine to change. This articl
e discusses how an analysis of the work of physicians involved in mana
gement fails to yield a clear analytic distinction between physicians
engaged in management and the behavior of others who have managerial r
esponsibility.