- R K Schreter: Sheppard Pratt Health Plan, Baltimore, Maryland 21204, USA. schreters@aol.com
Physicians are responding to payers' demand for one-stop shopping and providers' desire for increased autonomy by creating physician service networks. These provider-owned and -operated delivery systems offer psychiatrists a model for creating their own behavioral health care organizations. The author describes features of these integrated delivery systems that can enable physicians to regain some of the control they have lost to managed care organizations. He encourages psychiatrists to view physician service networks as a valuable survival strategy in an era of change and uncertainty. Physicians who become involved in provider-owned networks must work to ensure that these organizations do not become indistinguishable from the managed care systems they replace.