Ethics In Managed Care Essay

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Introduction. Managed care steadily supersedes the indemnity and traditional fee-for-service plans of the past. The health care industry continues to evolve through managed care organizations (MCOs) by reducing health care costs while implementing high standards of quality care. MCOs, as described in the ensuing paper, attempt to balance morals and ethics with finances and physician-patient satisfaction. The Idea. Aside from shedding light on the controversial topic of managed care, the authors Mains, Coustasses, and Lykens seek to convey the idea of physician and patient roles within a complex system of health care delivery. They center their research on the idea of ethics, more specifically, how ethical standards affect the different roles…show more content…
The countless years spent in medical school to earn such a title do not begin to describe the ever-increasing role and responsibility a physician faces within managed care. Because of their valuable responsibility, the authors describe physicians as "gatekeepers" in health care, solely influencing both clinical and financial decisions (Mains et al., 2004). Managed care positions a physician with the decision-making power to ensure effective medical care while maintaining costs at a reasonable level. Physicians receive incentives for allocating resources with efficiency, such as only administering a routine examination once every other year to a healthy young adult with no significant family history of health problems. Control sits at the hands of these MCOs, as physicians are held accountable for the costs of services, simultaneously providing a high quality of care and services to every patient. In summary, the authors describe physicians as having the dual function of "financial advocate" and "patient fiduciary". Physicians can find themselves caught between dilemmas of reducing costs for the sake of hindering care quality or even raising quality services at a costly rate. Add "balancing act" to the list of knowledgeable talents performed by physicians in managed

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