Managed Care

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Abstract
The topic most discussed by physicians today is the increasing percentage of US health care being taken over by managed care organizations.1While physicians in practice are struggling to interpret the requirements and implications of contracts with emerging or established health care systems,2many academic medical centers have also joined the "dance of vertical integration."3,4What has not emerged from the ofttimes emotional discussions is a cogent examination of the impact of the transformation of medical practice from a cottage industry to a corporate enterprise on how we deliver care, assess and improve the quality of care, and educate future physicians. It is an urgent matter, then, for the medical profession to address the ethical principles that will preserve a sound physician-patient relationship within this rapidly changing environment. See also pp 323 and 330. To address the ethics of the physician-patient relationship in managed care realistically and

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