Likewise, the chapter by Norman Clemens, M.D., on private office practice and managed care is excellent. It contains a fine section on how to try to work with a managed care company by providing "progressive" psychiatric care. Another outstanding chapter is by Alan Stone, M.D., on the "paradigms, preemptions, and stages" of managed care. As always, Dr. Stone's insights and perspectives are penetrating. His discussion of ERISA (the Employment Retirement Income Security Act of 1976) as the statute that unleashed managed care is lucid and informative, and his forewarning about the power of potential oligopsonies in the psychiatric marketplace is chilling.