Conflicting values and the patient-provider relationship in managed care.
By definition, value in health care is a function of the quality of care received and the costs associated with providing the care. One method used to optimize the value function is managed care. Unfortunately, some mechanisms of managed care have created an environment where the values of primary stakeholders are in conflict with one another. One such area is the patient-provider relationship. We first explore five patient-provider relationship models and review pressures created by managed care and their impact on the patient-provider relationship. Finally, examples of proposed, pending, and passed legislation to protect the patient-provider relationship are reviewed along with characteristics of the ideal model of patient-provider interaction.
Stone
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Department of Health Management and Informatics, School of Medicine, University of Missouri-Columbia, USA.
Mantese
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D016265:Conflict of Interest / Q000191:economics / Q000331:legislation & jurisprudence; D003362:Cost-Benefit Analysis; D020793:Gatekeeping; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration* / Q000592:standards; D017146:Models, Organizational; D008960:Models, Psychological; D015279:Organizational Culture; D010344:Patient Advocacy; D010816:Physician Incentive Plans; D010817:Physician-Patient Relations; D012945:Social Values; D014481:United States; D014600:Utilization Review