title: Medical professionalism under managed care: the pros and cons of utilization review.
abstract: We contend that the full consequences of managed care for American medicine and health care professionals can be more fully understood if strategies for managing care are identified-in particular, strategies for the administrative oversight of professional decision making. In this paper we apply this perspective to the study of third-party utilization review, making use of a national survey of firms contracting to provide prior authorization for hospitalization in 1992. Survey data suggest that (1) existing approaches to utilization review differ greatly among review firms; (2) review practices that might improve agency and accountability seem to be overlooked by most review firms; and (3) a large number of review firms employ practices that undermine professional autonomy in seemingly inappropriate ways.
authors.forename: M J
authors.initials: MJ
authors.lastname: Schlesinger
authors.forename: B H
authors.initials: BH
authors.lastname: Gray
authors.forename: K M
authors.initials: KM
authors.lastname: Perreira
mesh_terms: D003625:Data Collection; D003657:Decision Making; D008329:Managed Care Programs / Q000592:standards* / Q000706:statistics & numerical data; D017009:Professional Autonomy; D014481:United States; D014600:Utilization Review