title: Managed care in obstetrics.
abstract: Managed care has marched relentlessly through all fields of obstetric care: individual and group practices, proprietary hospitals and academic medical centers, and public health systems. Emphasis on cost containment while preserving high quality has driven the redesign of healthcare delivery. A number of models for providing effective and less expensive obstetric care are now being examined in the USA and abroad. Increased market penetration by managed care will also exert profound and possibly harmful effects on traditional academic teaching institutions. These organizations must adapt to this new environment or face the erosion of physician support and training bases. Ultimately, significant moral and ethical dilemmas will arise when patients' best interests for care are being continually brought into conflict with the physician's need to earn a living.
authors.affiliation: Department of Obstetrics and Gynecology, BAA 700, Medical College of Geargia, Augusta 30912, USA.
authors.forename: L D
authors.initials: LD
authors.lastname: Devoe
mesh_terms: D018672:Community Health Planning; D003363:Cost Control; D003695:Delivery of Health Care / Q000458:organization & administration*; D004992:Ethics, Medical; D006801:Humans; D008329:Managed Care Programs / Q000458:organization & administration*; D008389:Marketing of Health Services; D017146:Models, Organizational; D009774:Obstetrics / Q000193:education / Q000458:organization & administration*; D011787:Quality of Health Care