Ethics in managed care

The high cost of medical care has created a crisis in access and quality of services and has led to rapid changes in the structure and financing of health care services. Managed care and managed competition are terms and techniques that have been invented in an effort to get a handle on the escalating cost of care. The financial pressures of health care on corporations and household budgets have forced many of the changes that clinicians are experiencing. The changing picture of treatment in the era of managed care is discussed, including confidentiality, conflicts of interest, informed consent, double agentry, honesty, and the doctor-patient relationship.