Reform is probably the most frequently used term when discussing health care systems. The literature is broad and general, with topics ranging from reasons for carrying out reform, through discussion and the meaning of the reform, to discussions of methods for reform in developing countries. Interest has been centered more on the definition of content and less on the processes of implementation. Implications in terms of changes in the requirements of health facilities and human resources have been only superficially addressed. This paper presents a conceptual framework to discuss the main issues involved in reform of the health care systems and the shifts in needs of human resources. Assessment of the ways in which reform affects the medical labor market require the application of a conceptual framework that enables us to focus more on process than content. In the organizational change literature, both in theory and practice, human resources have been found critical for the institutionalization of organizational change. They are also critical for assessing health care reform.