 |
|
Anticipated Changes in the Doctor-Patient Relationship in the Managed Care and Managed Competition of the Health Security Act of 1993
John La Puma, MD
Arch Fam Med. 1994;3(8):665-671.
Abstract
The doctor-patient relationship is the cornerstone of medical ethics, yet the relationship will change significantly under the Health Security Act of 1993. In a way, man-aged care and managed competition are a return to the old medical ethics: doing everything reasonable and probably beneficial for all, instead of going all out for each. Five central questions may help physicians and policy makers anticipate a paradigm shift in ethics. An analysis of these questions suggests that managed care and managed competition challenge physicians' roles as trustworthy patient advocates. Fortifying doctor-patient relationships in man-aged care would be prudent and wise and would help to achieve the ethical allocation of limited resources. By protecting patients' personal medical interests and empowering patients to do the same, doctors can attempt to safeguard trust. Both doctors and patients want to have strong, personal, values-oriented relationships. Whether such relationships are possible under the Health Security Act remains to be seen.
Author Affiliations
From the Division of General Internal Medicine, the Department of Medicine, Lutheran General Hospital, Park Ridge, and the Section of General Internal Medicine, the Department of Medicine, the University of Chicago (Ill) Hospitals and Clinics.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Evidence That Consumers Are Skeptical About Evidence-Based Health Care
Carman et al.
Health Aff (Millwood) 2010;29:1400-1406.
ABSTRACT
| FULL TEXT
Switching to Gatekeeping: Changes in Expenditures and Utilization for Children
Ferris et al.
Pediatrics 2001;108:283-290.
ABSTRACT
| FULL TEXT
Continuity of Care, Informed Consent, and Fiduciary Responsibilities in For-Profit Managed Care Systems
Holleman et al.
Arch Fam Med 2000;9:21-25.
ABSTRACT
| FULL TEXT
Ethical Decision Making in Managed Care
Sorum
Arch Intern Med 1996;156:2041-2045.
ABSTRACT
Managed Care: Ethical Issues
La Puma
JAMA 1995;274:610-610.
ABSTRACT
Managed Care and Managed Death
La Puma
Arch Intern Med 1995;155:1553-1553.
ABSTRACT
|
