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Managed Care: Effects on the Physician-Patient Relationship

Published online by Cambridge University Press:  01 January 2000

ROBYN S. SHAPIRO
Affiliation:
Robyn S. Shapiro, J.D., is Professor of Bioethics and Director of the Center for the Study of Bioethics at the Medical College of Wisconsin, Milwaukee, Wisconsin.
KRISTEN A. TYM
Affiliation:
Kristin A. Tym, B.A., is Program Coordinator for the Center for the Study of Bioethics, Medical College of Wisconsin, Milwaukee, Wisconsin.
JEFFREY L. GUDMUNDSON
Affiliation:
Jeffrey L. Gudmundson, M.S., is a statistician with TAP Holdings, Inc., and formerly with the Division of Biostatistics at the Medical College of Wisconsin, Milwaukee, Wisconsin.
ARTHUR R. DERSE
Affiliation:
Arthur R. Derse, M.D., J.D., is Associate Clinical Professor of Bioethics and Associate Director for Medical and Legal Affairs of the Center for the Study of Bioethics at the Medical College of Wisconsin, Milwaukee, Wisconsin.
JOHN P. KLEIN
Affiliation:
John P. Klein, Ph.D., is Professor and Head of the Division of Biostatistics at the Medical College of Wisconsin, Milwaukee, Wisconsin.

Abstract

Over the past several years, healthcare has been profoundly altered by the growth of managed care. Because managed care integrates the financing and delivery of healthcare services, it dramatically alters the roles and relationships among providers, payers, and patients. While analysis of this change has focused on whether and how managed care can control costs, an increasingly important concern among healthcare providers and recipients is the impact of managed care on the physician–patient relationship. The literature includes a number of theoretical articles and anecdotal accounts of managed care's impact on the doctor–patient relationship, but little data have been collected and analyzed. We designed a survey for distribution to Wisconsin physicians to analyze the prevalence and types of managed care arrangements in the state, and the impact of these arrangements on physicians and their relationships with patients.

Type
SPECIAL SECTION: TERRA INCOGNITA: UNCHARTED TERRAIN BETWEEN DOCTORS AND PATIENTS
Copyright
© 2000 Cambridge University Press

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