In the wake of failed national health care system reform, the responsibility of crafting public policy to respond to changes in the health care system has fallen largely to state governments. Beginning in 1995, state policymakers focused intensively on managed care regulation, adopting policies on a broad array of issues with important implications for patients, physicians, and the physician-patient relationship. To a surprising degree, the regulatory activity in diverse health care markets across the nation has reflected a shared set of concerns about managed care practices and trends. An evaluation of the impact of these state policies will provide essential information about the most effective role for government in promoting the physician-patient relationship and the rights of patients and health care professionals in the era of managed care.