Many governmental programs that attempt to address non-point source pollution from animal feeding operations focus on approaches which almost exclusively utilize land-based best management practices (BMPs) to address water quality issues. While this approach may improve overall manure nutrient management, the results may be falling short of expectations because it does not recognize the real strategic issues facing many of today's dairy farmers in the Northeast and Mid-Atlantic regions. Market-based economics have resulted in an organizational pattern in modern dairy production whereby a significant proportion of feed for the dairy herd is no longer produced on the farm where the cows are housed. Whole-farm nutrient balances indicate that 60-80% of the nitrogen (N) and phosphorus (P) imported annually onto case study farms can not be accounted for in exports of milk, cattle or feed. This is leading to major nutrient accumulation and losses where animals are located with little economic incentive to redistribute the manure nutrients beyond that area. The land-based BMP approach is important and its implementation should reduce the immediate water quality impacts of intensive animal agriculture, but these practices do not address the larger nutrient imbalance/surplus that will ultimately drive the water (and air) quality problems. To be effective, the BMP approach should be expanded to include nutrient source reduction and/or manure nutrient export.