title: Trust and trustworthy care in the managed care era.
abstract: Trust is essential to the doctor/patient relationship, but trust in physicians' fiduciary ethic has become less plausible as a protector of patients' interests. The rise of managed care often is seen as undermining the fiduciary ethic and lessening the trustworthiness of care. But can managed care enhance that trustworthiness? Four possible sources of trustworthiness in managed care are discussed: ethical standards in the managed care industry, nonprofit organizations, physician control, and performance monitoring by purchasers. Limitations on all of these fronts suggest the continuing importance of a strong fiduciary ethic on the part of physicians who make patient care decisions.
authors.forename: B H
authors.initials: BH
authors.lastname: Gray
mesh_terms: D032781:Codes of Ethics; D016265:Conflict of Interest; D030881:Disclosure; D004992:Ethics, Medical; D018588:Fee-for-Service Plans; D033161:Government Regulation; D006801:Humans; D033181:Information Dissemination; D008329:Managed Care Programs / Q000191:economics / Q000592:standards*; D009939:Organizations, Nonprofit; D010344:Patient Advocacy; D010817:Physician-Patient Relations; D012941:Social Responsibility; D035502:Trust; D014481:United States