Hostname: page-component-7c8c6479df-nwzlb Total loading time: 0 Render date: 2024-03-29T06:27:29.560Z Has data issue: false hasContentIssue false

Conflicts of Interest and Management in Managed Care

Published online by Cambridge University Press:  01 April 2000

GEORGE J. AGICH
Affiliation:
George J. Agich, Ph.D., is the F.J. O'Neil Chair in the Department of Bioethics, The Cleveland Clinic Foundation, Cleveland, Ohio
HEIDI FORSTER
Affiliation:
Heidi Forster, J.D., is a Postdoctoral Clinical Bioethics Fellow at the National Institutes of Health

Abstract

The bioethics literature on managed care has devoted significant attention to a broad range of conflicts that managed care is perceived to have introduced into the practice of medicine. In the first part of this paper we discuss three kinds of conflict of interest: conflicts of economic incentives, conflicts with patient and physician autonomy, and conflicts with the fiduciary character of the physician–patient relationship. We argue that the conflicts are either not as serious as they are often alleged to be or not unique to managed care. In part two we argue that managed care represents a new paradigm for medical care that features a new concept of management. We discuss three types or levels of management that managed care highlights, namely, administrative, clinical, and resource, which together offer a more sophisticated vantage point from which to assess patient care. We do not endorse managed care, but attempt to highlight some of the positive changes brought by managed care that were difficult to attain under traditional reimbursement systems.

Type
SPECIAL SECTION: ISSUES IN ORGANIZATION ETHICS AND HEALTHCARE
Copyright
© 2000 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)