Medical education focuses on obtaining medical knowledge about the diagnosis and treatment of diseases at the individual physician-patient level and tends to put less emphasis on the system as a whole, as well as its impact on patient care, safety, and quality. The delivery of health care is very complex and generally known to be made up of a number of interdependent components and microsystems. Health care systems are also subject to external forces from payers, regulators, competitors, changing demographics, and market forces. As a systems thinker, the physiatrist needs to understand the role of rehabilitation medicine in his or her own health care system, his or her own role within that system, and look for patterns of interdependencies. Dynamic complexity is at work when an action has both local consequences in the health care system and also distant consequences somewhere else in that system.