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F. Peter Rescigno, MD
Glen Ridge, NJ

JAMA. 1986;255(11):1435.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

"Plus ça change, plus c'est la même chose,"¹ or is it? The author² states that, "In spite of all its great advances, what medicine is still all about is the patient, the physician, and the quality of the relationship that exists between them."

How is the quality of the relationship affected when patients see a doctor not of their choosing but the one selected or available from the roster of a health maintenance organization (HMO) or preferred provider organization? How is that relationship affected by the physician's knowledge that the patient did not necessarily choose that physician? How is the nature of the relationship affected by the physician's sense of his relatively diminished role as another employee in a corporation of many employees whose management may consider the bottom line on the financial balance sheet as the prime consideration of that corporation and may direct its . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Senior Contributing Editor; Sharon Iverson, Assistant Editor.

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