Learning to accentuate the positive in managed care

Article Abstract:

A physician tries to see the bright side of managed care. He now sees a greater variety of patients than before and tries to focus less on the individual patient and more on the health of the community. He finds it a challenge to keep up with the 1,200 different insurance contracts that his independent practice association handles, but believes this sharpens his intellectual skills. He and his staff do not worry about money because they never know how much they will be paid. He enjoys the protocols he receives from the HMO medical directors telling him how to treat specific diseases.

Personal narratives, Column, Physicians, Medical professions

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Primary care in the United States -- the best of times, the worst of times

Article Abstract:

Managed care was supposed to empower primary care physicians but it is unclear whether that has actually happened. Between 1950 and 1990, the number of specialists tripled while the number of primary care physicians decreased. The creation of managed care was supposed to reverse this trend by making primary care physicians gatekeepers who would coordinate all medical care. A 1999 study showed that one-quarter of the primary care physicians who were surveyed believed they were doing more work than they should be doing. Doctors in managed care plans were most likely to feel this way.

Beliefs, opinions and attitudes, Physicians (General practice), General practitioners

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Gatekeeping reconsidered

Article Abstract:

Primary and specialist medical care should be integrated in order to provide quality health care to patients with chronic diseases. This is not necessarily a gatekeeper model, in which patients can only see a specialist if they are referred by their primary care physician.

Medicine, Medical referral, Medical specialties

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