Corporately managed health care and the new role of physicians.
The roles described are not all-inclusive, since a small proportion of physicians, as in times past, will continue to pursue diverse careers outside of an tangential to health care. Neither are the roles mutually exclusive, as physician-managers are also organizational employees, as independently contracting professionals may also be partly fee for service, as physician entrepreneurs may be fee for service practitioners or contracting professionals, and so forth. The point is, that as the delivery of health care becomes a more complex and formalized process, and as large organizations delivering and insuring health care become more predominant, the various roles of physicians are becoming more distinctly obvious. What are the implications of this trend toward greater internal segmentation of the medical profession? At this juncture, they are not entirely clear. It could mean that some groups of physicians will achieve higher status and more rewards than other groups, which might result in greater conflicts within the medical profession. Undoubtedly, the emergence of corporately managed health care and the development of new (and possibly divergent) roles for physicians confronts the medical profession and its members with the gnawing questions of who they really are and what do they really want to be? Ultimately, the greatest challenge may be in finding a common set of commitments and values which transcend our many different roles, and which provide physicians with a clear and continuing sense of ourselves as medical professionals.
Winkenwerder
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Health Care Financing Administration, Department of Health and Human Services, Washington, D.C.
Nash
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D003132:Commerce; D003220:Conflict, Psychological; D003695:Delivery of Health Care / Q000639:trends*; D006269:Health Facilities, Proprietary / Q000191:economics; D006279:Health Maintenance Organizations / Q000458:organization & administration; D006292:Health Priorities; D008486:Physician Executives; D010819:Physician's Role; D011364:Professional Practice / Q000639:trends*; D012380:Role; D014481:United States