The impact of managed care on patients' trust in medical care and their physicians

Article Abstract:

Many aspects of managed care have eroded the trust that should exist between doctor and patient. Trust occurs when the patient believes the physician is competent and will act in the best interests of the patient. It also implies that the physician assumes responsibility for all health care decisions. This latter aspect of trust is directly violated by utilization review, which forces doctors to seek authorization for treatment plans from the patient's insurance company. Physicians in some managed care plans are subject to gag rules that limit what they can say to a patient. This limits open and honest communication, which is also a component of trust. Some primary care physicians are uncomfortable dealing with certain issues such as domestic violence or do not have specialty training to treat serious diseases such as AIDS. But if the physician acts as the patient's gatekeeper, the patient can not see another doctor for these conditions. Doctors should do all they can to maintain patient trust in the era of managed care.

Social aspects, Analysis, Physician and patient, Physician-patient relations, Ethical aspects, Breach of trust

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Managed care as a target of distrust

Article Abstract:

Managed care plans have become a target of physicians and patients alike. This is partly because of public perceptions of abuses such as early discharge after childbirth and an emphasis on profits. Physicians may feel their autonomy is threatened and may resist change. However, studies have shown that managed care has produced similar outcomes as fee-for-service plans in many areas and has reduced health care costs. Managed care organizations need to enhance their public image and they may be able to do this by collaborating with physicians.

Public opinion

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Are patients' office visits with physicians getting shorter?

Article Abstract:

The growth of managed care has not led to a reduction in the amount of time that doctors spend with their patients. Data from the National Ambulatory Medical Survey and the American Medical Association's Socioeconomic Monitoring System from 1989 to 1998 show that the amount of time doctors spent with patients actually increased by about one or two minutes.

Statistical Data Included, Statistics, Physician services utilization

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