The Doctor as Double Agent
Kennedy Institute of Ethics Journal. 1993 Sep; 3(3): 279-286.
American doctors in the 1990s are being asked to serve as "double agents," weighing competing allegiances to patients' medical needs against the monetary costs to society. This situation is a reaction to rapid cost increases for medical services, themselves the result of the haphazard development since the 1920s of an inherently inflationary, open-ended system for funding and delivering health care. The answer to an inefficient system, however, is not to stint on care, but rather to restructure the system to remove the inflationary pressures. As long as we are spending enormous resources on an inherently inefficient and inflationary system we cannot justify asking doctors to withhold beneficial care to save money for third-party payers. Doing so serves a largely political agenda and endangers the patient-centered ethic that is central to medicine.
Conflict of Interest; Costs and Benefits; Decision Making; Discrimination; Doctors; Economics; Health; Health Care; Health Care Delivery; Health Care Reform; Health Insurance; Health Maintenance Organizations; Historical Aspects; Hospitals; Incentives; Indigents; Insurance; Managed Care Programs; Medicine; Moral Obligations; Managed Care; Obligations to Society; Organizations; Patient Advocacy; Patients; Physician Patient Relationship; Physician's Role; Physicians; Policy Analysis; Public Policy; Resource Allocation;
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