The challenge of research patient recruitment is intensifying in the 1990s. Relevant factors include the often negative impact of the press, increasing competition for patients, an increasingly ethnically diverse population, and a pervasive trend toward managed care. Based on preliminary findings from a patient focus group, 550 patients were contacted by mail and asked to complete a 25-item questionnaire. Survey results indicate that for most study patients initial telephone contact with a health care professional is not as important as the perception of a genuinely caring (i.e., "non-guinea pig") environment. Office location and other intangibles also affect recruitment; furthermore, several of the benefits sought by volunteers transcend ethnicity. The trend toward managed care will not impede and may enhance research patient recruitment. This research provides information and data that will enable investigators and sponsors to better meet the challenges of patient recruitment in the 1990s.