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Megamarketing, as coined by Kotler (1968), is a strategic way of thinking which takes an enlarged view of the skills and resources needed to enter and operate in obstructed or protected markets. The concept of megamarketing emphasizes the mastering and coordination of economic, psychological, political, and public relation skills and suggest that organizations can take a proactive stance in shaping macroenvironmental conditions. As health care delivery is characterized by a highly regulated environment, this marketing approach has definite applications for the health care marketer.

Having reduced the unit cost of physician fees during the 1980s, the federal government set up a Medicare pilot study in the state of Georgia in 1989 to test the impact of its cost containment strategies aimed at reducing volume of services. This research has attempted not only to clarify the nature of physician reaction to the Medicare pilot study and to quantify the level of the dissatisfaction, but also to provide a richer understanding of the dynamic meaning of the dissatisfaction that Georgia physicians feel.