The two cultures and the health care revolution. Commerce and professionalism in medical care
J. H. McArthur and F. D. Moore
Harvard Business School, Boston, MA, USA.
The current trend toward the invasion of commerce into medical care, an
arena formerly under the exclusive purview of physicians, is seen by the
authors as an epic clash of cultures between commercial and professional
traditions in the United States. Both have contributed to US society for
centuries; both have much to offer in strengthening medical care and
reducing costs. At the same time, this invasion by commercialism of an
arena formerly governed by professionalism poses severe hazards to the care
of the sick and the welfare of communities: the health of the public and
the public health. Some of these hazards are briefly listed and reviewed,
together with a brief outline of standards that might be established
nationally to abate these hazards. A national agency in the private sector
is proposed, the National Council on Medical Care, to set standards and
provide an approval mechanism that would then be the basis for state
enforcement through licensing. Two models for such an initiative are
outlined, one based on the National Academy of Sciences as the initiating
force, and the other on an initiative provided by a consortium of national
charitable foundations interested in health policy. In both cases, wide
support from the national foundations would be essential. In the case of
the academy model, some government funds might also be available without
loss of the freedom of a private-sector initiative. Some operational
options for such a national council, its membership, and the conduct of its
affairs are briefly outlined as a basis for further discussion.
Regulatory Challenges and Non-profit Welfarism: Implications and a Sustainable Framework for Choice
Ravichandran
Journal of Health Management 2006;8:261-294.
ABSTRACT
Bringing Managed Care Home to People With Chronic, Disabling Conditions:: Prospects and Challenges for Policy, Practice, and Research
Kodner and Kyriacou
J Aging Health 2003;15:189-222.
ABSTRACT
Finding Soul in a "Medical Profession of One"
Hafferty
Journal of Health Politics, Policy and Law 2003;28:133-158.
Mirror, Mirror on the Wall: Are We Prescribing the Right Psychotropic Medications to the Right Children Using the Right Treatment Plan?
Jellinek
Arch Pediatr Adolesc Med 2003;157:14-16.
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Relationship of Hospital Teaching Status With Quality of Care and Mortality for Medicare Patients With Acute MI
Allison et al.
JAMA 2000;284:1256-1262.
ABSTRACT
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Physician Views on Practicing Professionalism in the Corporate Age
Castellani and Wear
Qual Health Res 2000;10:490-506.
ABSTRACT
Continuity of Care, Informed Consent, and Fiduciary Responsibilities in For-Profit Managed Care Systems
Holleman et al.
Arch Fam Med 2000;9:21-25.
ABSTRACT
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Effect of the Ownership of Dialysis Facilities on Patients' Survival and Referral for Transplantation
Garg et al.
NEJM 1999;341:1653-1660.
ABSTRACT
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The Social Organization of Physician-Managers in a Changing HMO
HOFF
Work and Occupations 1999;26:324-351.
ABSTRACT
Of Geese and Golden Eggs
MCCOLLOUGH
JBJS 1999;81:303-5.
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Effects of Managed Care on Physician-Patient Relationships, Quality of Care, and the Ethical Practice of Medicine: A Physician Survey
Feldman et al.
Arch Intern Med 1998;158:1626-1632.
ABSTRACT
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American Medicine Is on the Right Track
Greenberg
JAMA 1998;279:426-428.
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