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Ethics, Physician Incentives and Managed Care

Alberto Coustasse, MD, MBA, MPH, DrPHc, Department of Social Behavioral Sciences, School of Public Heatlth, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107-2699, 817-735-0150, coustasse@hotmail.com, Douglas Mains, DrPH, Department of Health Management and Policy, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107, and Kristine Lykens, PhD, Department of Health Management and Policy, Univ of North Texas - School of Public Health, 3500 Camp Bowie Blvd, Fort Worth, TX 76107-2699.

The authors review the principle features of the managed care system in an effort to understand the ethical assumptions inherent in managed care. The interrelationships among physician incentives, responsibilities of patients and the physician-patient relationship are examined in light of the ethical concerns identified in the managed care system. The managed care system creates ethical tensions for those who influence the allocation of scare resources. Managed care’s administrative controls have increasingly changed the doctor-patient relationship to the businessperson-consumer relationship. Managed care goals of quality and access demand that physicians be both patient advocate and organizational advocate, even though these roles seem to conflict. A reemphasis of managed care’s moral mission is essential for enabling physicians, patients, payers and policymakers to fulfill their new role and to preserve the fidelity of the doctor-patient relationship.

Learning Objectives:

Keywords: Ethics, Managed Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Research and the Public Interest

The 132nd Annual Meeting (November 6-10, 2004) of APHA