Healthcare reform is now a reality, and those reforms create a very different medical practice environment. Although many of the changes will not be implemented immediately, physicians should begin now to position themselves to take advantage of opportunities the law offers and to protect themselves against potential pitfalls; they can act today on measures which will enable their practices to benefit from incentives that will become available as reforms are implemented. Attorneys can help strategically and with legal issues, but physicians can take steps to help themselves. This article focuses on steps that can be taken in three areas: fraud and abuse, creating value, and physician-hospital relationships.