Managed Competition and the Patient--Physician Relationship
Emanuel, Ezekiel J.
Brett, Allan S.
New England Journal of Medicine. 1993 Sep 16; 329(12): 879-882.
There has been little discussion of how managed competition might affect the patient-physician relationship. However, the effect of any reorganized health care system on this relationship deserves more than an afterthought, since the interaction between patient and physician is the final common pathway through which reforms will be played out. In the short term, the success or failure of any new model will undoubtedly be judged primarily by its economic consequences. But the ultimate stability of the model will also hinge on the quality of the patient-physician relationships that emerge in the longer term. Various aspects of the structure of managed competition make us concerned that it would undermine this fundamental relationship.
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