Physician autonomy in the managed care era: the physician-citizen or subject?
Until recently, medicine was one of the few areas in which an individual could practice a profession as a citizen member of the organization. However, in the recent overhauling of medical organizations in search of cost efficiency, physicians have moved from self-governing organizations with the rights of citizen participation to autocratic, centrally controlled organizations with little for physicians to do but provide high-quality manual labor. The principles of prosperity and choice espoused in The Federalist Papers are governance principles that can re-establish citizenship in medical groups.
Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda University School of Public Health, CA 92354, USA. Bafisher@alumni.utexas.net
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D008329:Managed Care Programs / Q000458:organization & administration*; D019982:Organizational Case Studies; D010818:Practice Patterns, Physicians' / Q000639:trends*; D017009:Professional Autonomy; D014481:United States