1. MANAGED CARE
BOON OR
BOONDOGGLE

2. BACKGROUND ISSUES MAJOR CONCERNS ACCESS COST CONTROL
BASIC BENEFITS PACKAGE
WHAT TO INCLUDE
WHAT TO EXCLUDE
ADVANTAGES
LESS TIME IN HOSPITAL
DEVELOPMENT OF OUT-PATIENT SURGERIES
FEWER UNNECESSARY TESTS

3. PHYSICIAN-PATIENT RELATIONSHIP
ECONOMIC INCENTIVES
FEE FOR SERVICE --- PAID FOR WHAT THEY DO
MANAGED CARE --- PAID FOR WHAT THEY DON’T DO
MAINTAIN THE ADVOCACY ROLE
DIVIDED ALLEGIANCE --- CONFLICTS OF INTEREST
PHYSICIAN AS GATE-KEEPER
QUALIFIED FOR SPECIAL PROBLEMS?

4. SPECIAL STIPULATIONS RESTRICTIONS ON INFORMED CONSENT
VOLUME OF PATIENTS
REFERRALS TO SPECIALTIES
EXPULSION FROM PLAN
PHYSICIAN RESPONSIBILITY FOR STIPULATION IN THE PLAN