0
ARTICLE |

The Impact of Managed Care on Patients' Trust in Medical Care and Their Physicians

David Mechanic, PhD; Mark Schlesinger, PhD
JAMA. 1996;275(21):1693-1697. doi:10.1001/jama.1996.03530450083048.
Text Size: A A A
Published online

Social trust in health care organizations and interpersonal trust in physicians may be mutually supportive, but they also diverge in important ways. The success of medical care depends most importantly on patients' trust that their physicians are competent, take appropriate responsibility and control, and give their patients' welfare the highest priority. Utilization review and structural arrangements in managed care potentially challenge trust in physicians by restricting choice, contradicting medical decisions and control, and restricting open communication with patients. Gatekeeping and incentives to limit care also raise serious trust issues. We argue that managed care plans rather than physicians should be required to disclose financial arrangements, that limits be placed on incentives that put physicians at financial risk, and that professional norms and public policies should encourage clear separation of interests of physicians from health plan organization and finance.

(JAMA. 1996;275:1693-1697)

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();