In the last decade, the delivery of health care and the role of the physician have undergone radical change. With the advent of managed care and the tightening of restrictions by Medicare and insurance companies, physicians have been required to review, re-engineer, and revitalize their role. Increasing financial pressures at the hospital level have caused administrators to cut costs at all levels. It is imperative that physicians take an active role in cost containment so that the quality of care is not sacrificed. Cost containment in vascular surgery is an urgent priority in health care. Copyright (C) 2000 by W.B. Saunders Company.