Physicians' Perceptions of Managed Care
Levine, Robert A.
American Journal Of Managed Care. 1998 Feb; 4(2): 171-180.
We wished to determine physicians' views and knowledge of managed care, particularly their beliefs about the provisions of managed care contracts in terms of legality and ethics. A questionnaire was sent to the 315 physicians of the medical staff of Norwalk Hospital in Connecticut regarding managed care and managed care contracts. Sixty-six responses were received within a 45-day period (20.9% return). Although only 1 of 11 contract provisions presented in one section of the questionnaire was illegal in Connecticut, a majority of physicians believed 7 of the 11 were illegal. On average, 50% of physicians polled thought each of the provisions was illegal, and a varying majority of physicians (53% to 95.4%) felt the various provisions were unethical. The majority of respondents (84.8% to 92.4%) believed that nondisclosure provisions were unethical. Ninety-seven percent thought managed care interferes with quality of care, and 72.7% of physicians felt that the managed care industry should be held legally responsible for ensuring quality of care. However, 92.4% of physicians considered themselves to be ethically responsible for ensuring quality of care. Physicians have a poor understanding of the legal aspects of managed care contracts but feel strongly that many provisions of these contracts are unethical. Physicians also believe that managed care is causing medicine to be practiced in a manner that is contrary to patients' interests and that legal recourse is needed to prevent this.
Advance Directives; Allowing to Die; Alternatives; Attitudes; Contracts; Decision Making; Disclosure; Economics; Ethics; Futility; Gatekeeping; Government; Government Regulation; Health; Health Care; Incentives; Industry; Knowledge; Legal Aspects; Legal Liability; Liability; Managed Care Programs; Medical Ethics; Medicine; Managed Care; Patient Advocacy; Patients; Physicians; Quality of Health Care; Questionnaires; Regulation; Remuneration; Resuscitation; Resuscitation Orders; Survey; Withholding Treatment;
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