managed care

The Exit Interview

Author: 
Lawrence R. Huntoon, MD, PhD
Article Type: 
Medical Ethics and Managed Care
Issue: 
January/February 1999
Volume Number: 
4
Issue Number: 
1

The year is 2025. In an attempt to understand the tragic demise of American medicine in the tradition of Hippocrates, we look back on the course of events around the turn of the century.

Managed Care Is Inherently Unethical and Should Be Scuttled

Author: 
Robert P. Gervais, MD
Article Type: 
Commentary
Issue: 
January/February 1999
Volume Number: 
4
Issue Number: 
1

Dear Dr. Spaeth:
I was pleasantly surprised to receive your letter which briefly discusses the ethical concerns I have about the managed care organization (MCO) philosophy. The theoretical underpinnings of the MCO concept are wrong on both utilitarian and moral grounds. Having made such a sweeping assertion, let me attempt to explain my position which many regard as extreme but others view as simple common sense.

Managed Care --- A Review

Author: 
Thomas Dorman, MD
Article Type: 
Feature Article
Issue: 
January/February 1999
Volume Number: 
4
Issue Number: 
1

In contemporary America, we are suffering from a lack of concepts, a philosophical vacuum recognized first by Ayn Rand. Nowhere is this more marked than in the fascist take over of the oldest profession. The ethics of physicians have been wardens of Western traditions since the days when Hippocrates formulated his famous Oath. The personal relationship and direct individual responsibility between physician and patient, the laissez faire capitalist system, was encapsulated in the honorable commitment to the patient, long before Ludwig von Mises wrote Human Action.

Thriving Outside Managed Care

Author: 
Joel Kahan, MD
Article Type: 
Correspondence
Issue: 
May/June 1999
Volume Number: 
4
Issue Number: 
2

A colleague psychiatrist shared with me the article "Thriving Outside Managed Care" by Dr. Robert Emmons (Medical Sentinel, Vol. 3, No. 6). This is an inspirational article. It contains what I believe psychiatry and medicine is all about. Dr. Emmons exemplifies what taking personal responsibility as a physician must be for every physician today.

Schubert's "Unfinished Symphony" Reviewed

Author: 
Robert J. Cihak, MD
Article Type: 
Parody
Issue: 
July/August 1999
Volume Number: 
4
Issue Number: 
4

The Director of Health Care Services in San Francisco County is a community leader, and a great lover of the San Francisco Symphony, to which he has season tickets. Recently, he could not attend a performance, so he gave the tickets to a deputy administrator, in charge of managed care and cost containment. The next day he asked the deputy how he enjoyed the performance. Instead of the usual polite remarks, the seasoned bureaucrat handed him the following memorandum:

The Rise of Managed Care --- Is Capitalism to Blame?

Author: 
David T. Springer, MD
Article Type: 
Commentary
Issue: 
July/August 1999
Volume Number: 
4
Issue Number: 
4

Managed care has been appropriately criticized for overt and hidden restriction of medical care conflicts of interest, invasion of the doctor-patient relationship, and greatly diminished confidentiality. Observing the increasing corporate takeover of medicine, many blame capitalism for the rise of managed care practices.

Futility of Care Guidelines and The Killing Fields of the Future

Author: 
Lawrence R. Huntoon, MD, PhD
Article Type: 
Medical Ethics and Managed Care
Issue: 
November/December 1999
Volume Number: 
4
Issue Number: 
6

It is no coincidence that the debate over physician-assisted suicide and euthanasia has arisen at a time when managed care has been forced on employees and socialized medicine is being surreptitiously implemented in a piecemeal fashion in our country. There has been increasing talk of a "right to die" and of "death with dignity." Marching close behind those who insist on the "right to die" are those who feel it would be in society's best interest to create a duty to die.

Managed Care Psychosis

Author: 
Lawrence R. Huntoon, MD, PhD
Article Type: 
Medical Ethics and Managed Care
Issue: 
January/February 2000
Volume Number: 
5
Issue Number: 
1

Recently, I was asked to see a patient in neurologic consultation because he had reportedly displayed "irrational behavior." He had been admitted to the locked psych ward with a diagnosis of psychosis not otherwise specified which translates to "haven't the foggiest idea what's wrong, but I think he's crazy." He was a very pleasant, soft spoken elderly man and after I introduced myself, he sat down and calmly related the following story.

Idaho

Author: 
Vernon L. Goltry, MD
Article Type: 
Report from the States
Issue: 
May/June 2000
Volume Number: 
5
Issue Number: 
3

On September 1, 1999, Regence BlueShield of Idaho announced a unilateral abandonment of a part of their contract with physicians and added a unilateral amendment without physician approval. On the first count they completely abandoned usual, customary, and reasonable reimbursement rates and secondly introduced the RBRVS system of payment, reducing physician reimbursement especially on surgical procedures by anywhere from 30 to 90 percent from the current, sharply discounted, fee schedule in existence.

Physician Unions Not the Answer to Managed Care

Journal/Website: 
NewsMax.con
Article Type: 
Commentary
Published Date: 
Saturday, September 2, 2000

As we reach Labor Day 2000, physicians and the public should wonder what has happened in the many months that have transpired since the AMA decided to form physician unions and thus aligned itself with the conglomeration of special interests of the left side of the political spectrum.