title: Managed care's Achilles heel: ethical immaturity.
abstract: How can physician executives determine the prevailing values in the managed care arena? What are the consequences when values statements are ignored during decision-making? These questions can be answered using a process called ethical reasoning, which is different and more productive than making moral judgments, such as "is managed care good or bad?" Failing to include ethical reasoning in executive offices and boardrooms is a form of ethical immaturity. It fuels public suspicion that managed care's goal may be maximizing profit at all costs, as opposed to seeking reasonable profit through provision of dependable and accessible health care services. One outcome of ethical reasoning is rediscovering the basic truth that running one's business on competitive rather than altruistic principles is ethical whenever greater efficiencies and economic growth enlarge the size of the pie for everyone. Reasonable self-interest is a perfectly acceptable reason to act ethically. The time has come for physician executives to develop a basic understanding of pragmatic ethics, and to appreciate the value of adding ethical reasoning to the decision-making process.
authors.affiliation: richthom@aol.com
authors.forename: R E
authors.initials: RE
authors.lastname: Thompson
mesh_terms: D000533:Altruism; D003659:Decision Making, Organizational; D004465:Economic Competition; D004992:Ethics, Medical; D006801:Humans; D008128:Logic; D008329:Managed Care Programs / Q000458:organization & administration*; D010686:Philosophy, Medical; D008486:Physician Executives / Q000458:organization & administration* / Q000523:psychology*; D011340:Problem Solving; D011361:Professional Competence