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April 10, 2007
Managed care vs. Hippocratic Oath?
Health insurance premiums are rising, reimbursements to physicians are decreasing, and yet insurance companies are thriving. But, that’s business and not the central issue when a patient is not given the respect, and compassion due to anyone who comes before a physician seeking help.
Most state medical boards stress the importance of the patient-physician relationship, some emphasizing that it is “unethical for a physician to allow financial incentives or contractual ties of any kind to adversely affect his or her patient care” (www.ncmedboard.org) This creates an inherent conflict, as most physicians are still playing by the rules set forth by insurance companies. Physicians recognizing the primacy of patient autonomy, and the sacredness of the doctor-patient relationship based on mutual trust, quite frankly, are in a quandary.
Physicians are not taught how to run a business, this is true. But more importantly, most are not willing to buck the system and just say “no” to managed care, or become politically active. They all know that 8 minutes is not enough time for an office visit. It shouldn’t matter whether it takes 12 years to complete medical training, or that professional liability insurance costs are rising.
I would like to see physicians take less time explaining “why”, and instead channel their embitterment in a positive way. For some to be true to their calling, means taking financial risks by opting out of managed care plans or insurance firms that constrain patient care. How can this be wrong when medical boards have clearly stated any delivery of care decision that has been negatively affected by a physician’s contractual ties constitutes unethical behavior?
Insight Psychiatry
www.insight-psychiatry.com
13123 Rosedale Hill Ave.
Huntersville, NC 28078
704-948-3810
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