There is good news, and there is bad news. The good
news is that in my experience, younger physicians
generally are much more concerned about the cost of clinical
tests and treatments, and about justly distributing finite
medical resources, than were those who practiced medicine
in the fee-for-service era. The bad news has at least three
components. First, with respect to medically nonbeneficial
treatment in the ICU, managed care has not yet given evidence
of wanting to put the brakes on unrealistic family demands
for aggressive medical interventions. Second, managed care
is frustrating many healthcare professionals as well as
patients. And third, managed care has no apparent interest
in addressing, and may even have contributed to, the problem
of medical indigence. Let me develop these propositions
more fully.
Managed care: Future good news or bad news for vascular surgeons