In this book, the authors provide a detailed and informative analysis of how academic psychiatry is being affected by and is adapting to the changes brought about by managed care. The senior editor and author, Dr. Roger Meyer, is uniquely suited to make this analysis, having spent more than two decades in roles that include department chair, director of a faculty practice plan, executive dean of a school of medicine, and vice-president for health affairs at a health sciences center. The book, which was written as part of a project funded by the MacArthur Foundation, benefits from Dr. Meyer's detailed understanding of the complex functioning of departments and academic health centers. Dr. Meyer adds to his own experiences by including data from surveys of departments of psychiatry around the country and in-depth case studies of six departments, outlining their specific attempts to adapt and thrive.