Belief-practice gaps are common, particularly in complex and difficult areas, such as smoking, risky sexual behavior, domestic violence, physical inactivity, and atherogenic diets. The gaps exist partly because medical schools and residency programs have provided little effective training in these areas (although, in fairness, this is beginning to change). Lack of training not only deprives trainees of important skills but also sends a strongly negative social message: that the care of such problems is not a part of “real” medicine. But gaps between belief and practice also exist because there are no magic bullets (so to speak) for problems like gun violence; there are no penicillins that will prevent or cure smoking, risky sexual practices, or any other behaviors gone awry. On the contrary, dealing effectively with the growing array of socially and emotionally loaded behavioral issues now dropped in physicians' laps is hard, frustrating work. It requires sharing expertise and control with members of a multifaceted care group; it demands efficient communication, energy, and time. Pulling together the resources for such complex, integrated care has never been easy, and the dynamics of managed care may not be making the task any easier .