The turbulence and uncertainty that physicians have experienced in the last 20 years in adapting to the multiple forces transforming the delivery of healthcare will continue and likely increase. Cost pressures, quality issues, increasing competition, and burgeoning scientific and technological innovations are challenging the way healthcare is delivered. Confronting these issues will result in a major redirection and realignment in physician practices across the delivery spectrum, including the types of services provided and the ways they are delivered, practice organization, and provider and patient relationships.

This chapter reviews the current status and trends in the practice of medicine and discusses future directions for physician practice, both obvious and not so obvious, as the medical profession advances to the next generation of practice. The forecasts, while potentially disruptive in the shorter and even longer run, do not consign the medical profession to a bleak future in terms of professional satisfaction and stature. In fact, medical practitioners who are able to adjust to these changes by actively advancing their stake in the continuing evolution of healthcare will survive and even prosper. With change comes opportunity, including the prospect of new tools and systems that, while fundamentally changing physician practice in many ways, will advance the quality of care that the medical profession can provide.