Managed care and neurologists: Ethical considerations
Citation Manager Formats
Make Comment
See Comments
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
The growing influence of managed care organizations (MCOs) in the mid-1990s has diminished the professional authority of physicians and created conflicts of interest that threaten the traditional patient-physician relationship, sometimes to the detriment of patient welfare. The covenant of trust on which medicine is grounded is significantly threatened.1 In January 1995 the Council on Ethical and Judicial Affairs of the American Medical Association identified some of the ethical problems inherent in MCOs, described how patients could be harmed as a result, and provided guidelines for all physicians to follow to minimize the risk of such harms to patients.2 Recognizing the impact of these problems, the American Society of Internal Medicine offered a number of recommendations for MCOs and physicians in a series of policy papers issued in August 1995.3 The American Academy of Neurology endorses these guidelines and recommendations insofar as they apply to neurologists in the care of their patients, with emphasis and modifications as follows:
1. The interests of patients are paramount. Access of patients to optimal neurologic care may be restricted by a variety of "gatekeeping" functions inherent in MCOs. Nevertheless, it is essential that neurologists provide the best care that modern neurology has to offer, on a timely and efficient basis. What is best care for an individual patient should be based on peer-reviewed, validated outcomes data that demonstrate effectiveness, when such data are available. Guidelines and protocols …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Dr. Dennis Bourdette and Dr. Lindsey Wooliscroft
► Watch
Related Articles
- No related articles found.
Alert Me
Recommended articles
-
Issues of Neurologic Practice
Attitudes of US neurologists concerning the ethical dimensions of managed careJames L. Bernat, Steven P. Ringel, Barbara G. Vickrey et al.Neurology, July 01, 1997 -
Presidential Address
Practicing neurologyA delicate balanceSteven P. Ringel et al.Neurology, May 01, 1999 -
Issues Of Neurological Practice
US neurologistsAttitudes on the US health care systemSteven P. Ringel, Barbara G. Vickrey, Teresa L. Rogstad et al.Neurology, July 01, 1996 -
Articles
US neurologists in the 1990sTrends in practice characteristicsR.G. Holloway, B.G. Vickrey, C.M. Keran et al.Neurology, April 01, 1999