This is one of a series of articles appearing in the December 1990 issue of the Journal of Occupational Medicine that discusses occupational physicians' changing roles in health resource management. Here, an argument is made that occupational physicians are ideally situated to become leaders in assuring that employees and their dependents receive medical care of value. This, rather than ''health care cost containment'' (a phrase commonly used by corporations), is the proper goal of physicians as they join with others to limit the rise in health care costs. Virtually everyone involved - employers, employees, and care providers - agrees that better care would also be cheaper care, given the apparent current excess of medical procedures being performed. Physician involvement can also steer corporate policy toward rewarding physicians who take responsibility for maintaining excellent practice standards, rather than depending on surveillance-oriented approaches, such as those that require second surgical opinions or precertification. Under such a plan, physician groups that deliver high-quality, cost-effective care would be rewarded by the referral of more patients. Everyone would benefit, and costs would be reduced further by matching patients appropriately with the level of care they need. Presently, corporations steer patients to particular kinds of care through economic incentives (or disincentives); better awareness of quality would provide other, more significant, incentives. Both corporations and employees need physician input of solid medical advice and support, as well as the provision of leadership for occupational and corporate health care management. Will practitioners of occupational medicine rise to the occasion? Filling such roles may require changes in the ways occupational medicine physicians perceive themselves and their position in the medical community. At the same time, physicians without a background in occupational medicine who want to become involved in planning employee health care need to learn the basics of the specialty. (Consumer Summary produced by Reliance Medical Information, Inc.)