Effects of Managed Care

Effects of Managed Care

        A survey of 1011 Primary Care Physicians (PCP) was conducted on the effects of managed Care (MC) and the effects it has on the physician-patient relationship, ethics, and Quality of Care.  PCP where asked if there was an impact on their physician-patient relationships, their ability to carry out their professional ethical obligations and quality of patient care.

        The results of the survey concluded that 55% of the physicians felt under managed care they are less likely to place conflicts of interest and less likely to place the best interest of the patient first. They also stated that limitations on the length of hospital stays, diagnostic test, and choice of specialist where affected.  There was a 27-49% stated that there is a decrease in the physicians ethical obligations, respect of patient autonomy, and respect of confidentiality. The survey also concluded that female physicians where more negative towards MC.

Managed Care has put the PCP in a position where they are having responsibility for the financing as well as the provision of care. This puts the physician in a position of the “gatekeeper” and has the PCP responsible for cost containment which is where the physicians feel it is threating their relationship with their patients by having less time with their patients because, managed care is pushing for productivity and lower cost.

Physicians found under managed care that there was a decrease in the quality of patient care because, of the limitations set for the patient to choose specialist, sites for diagnostic testing, procedures and length of hospital stays. Ethical issues that arise for physicians were that managed care made it so the PCP was unable to put the best interest of the patient first. Physicians do try and put the best interest of their patient first but, are finding out in some cases financial disincentives keep them from doing so. Managed Care create an incentive not to care for complicated patients because, of the time, effort, and phone calls required by the PCP and his/her staff to obtain services for patients which in turn effects the physician-patient confidentiality.