Abstract
Managed care is changing the way in which healthcare delivery is organized and the way in which individuals' basic health needs are met. Although there is great expectation that an increase of primary healthcare providers (physicians, nurse practitioners, physician assistants) will result in better healthcare services, prevailing patterns of health professional distribution raise serious questions about healthcare delivery in rural areas. Nurse executives in rural areas must be alert to emerging needs and organize the nursing delivery system in ways that capitalize on the availability of practicing registered nurses-in the face of shortages of physicians, nurse practitioners, and physician assistants.