Managed care's continual rise will impact each Virginia area market uniquely. Although almost all physicians will be affected in some way by managed care, the level and type of impact will vary greatly depending on the physician's geographic location, specialty, practice type, practice size, hospital affiliations and existing managed care affiliations. Staying abreast of the constant changes in the public and private sector will become increasingly crucial for all of Virginia's physicians as management of resources and care plays a larger role in the health care delivery system.