title: Ethical issues of managed care.
abstract: In a competitive, monetized medical system, a clash of principles is inevitable; however, amid the tumult in the medical marketplace, the underlying tenets of emergency medical ethics remain inviolate. Although the goals of providing excellent and cost-effective care are not mutually exclusive, the conflicts encountered can only be resolved by appeal to a higher goal: the good of the patient. Both MCOs and EPs must function as agents of individual patients first and foremost. The enterprise of healthcare rests on fidelity, integrity, and trust; therefore, physicians and MCOs must accept and take seriously their important moral, legal, and social obligations to patients and society. Otherwise, third-party cost considerations and provider greed irreversibly could pervert the practice of medicine and destroy the last vestiges of fidelity in the patient-physician relationship.
authors.affiliation: Department of Emergency Medicine, Mercy Hospital of Pittsburgh, PA, USA. glarkin+@pitt.edu
authors.forename: G L
authors.initials: GL
authors.lastname: Larkin
mesh_terms: D016265:Conflict of Interest; D003363:Cost Control; D003362:Cost-Benefit Analysis; D004635:Emergency Medicine / Q000458:organization & administration / Q000592:standards*; D004992:Ethics, Medical; D015276:Health Care Rationing / Q000458:organization & administration; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration / Q000592:standards*; D008389:Marketing of Health Services; D019982:Organizational Case Studies; D010344:Patient Advocacy; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation / Q000458:organization & administration; D012051:Reimbursement Mechanisms / Q000458:organization & administration; D014481:United States