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Abstract
The emergence of health maintenance organizations (HMOs) has kindled considerable debate. The issues in question include the role of the physician as gatekeeper,1 , 2 the offering of monetary incentives to physicians for restricting the use of health care services,3 , 4 the conflicting obligations of physicians to the corporation and the patient,4 , 5 and the corporation's conflicting obligations to patients, corporate clients, and stockholders.6 There is also concern that primary care and medical subspecialties that lack a technological orientation may be dehumanized.7 On the other hand, staff-model HMOs also promise improved efficiency and reduced costs because of the emphasis on preventive health care and . . .
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