Physicians' time is under assault in the current health care system. In particular, managed care payers are reducing compensation to physicians on a discounted fee-for-service basis. More demanding consumers, complex new technologies, and increased managerial and administrative burdens are placing further constraints on physicians' time. As we look ahead, it seems likely that these pressures will intensify and transform the ways in which physicians spend their time. Physicians will play eight key roles in the future: clinical data collector, shaman, health advisor and wellness coach, knowledge navigator, proceduralist, diagnostician, physician manager, and quality assurance specialist. They will need to lead the redesign of these roles and define the ways in which they should spend their time in the health care system of the new millennium.