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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Regarding Alpert's commentary,¹ the transition to managed care has to be seen as at least bittersweet. The "joys" of professional practice as Alpert remembers them were no longer affordable to a government committed to represent our national patient base. Projections were ignored, excesses were denied or explained away, and the forces of change came roaring down the track, unabated and with a vengeance.

Fear not! The pendulum will likely swing back—not all the way to the "good old days," but certainly far enough back to allow the practitioner to minister to his/her patients with a little more elbow room, consonant with the new economic realities. Fees will be a little better, but the hours and the professionalism will be exacted without diminution.

Despite the "joyless" perceptions of physicians, some good things have come about amid the "pain" of managed care; things that had no signs of developing before managed care. . . . [Full Text of this Article]