When a doctor works for an HMO, he can only do what the HMO allows him to do. We are under strict utilization review guidelines. Something called economic credentialing has been taking place (doctors who spend too much are kicked out of the HMO0, this got so bad, that only about a year ago, congress passed some laws against economic credentialing. You have no idea what it is like for a doctor to say to a patient, I am sorry but your plan will not approve the test, or the treatment.
Read this again:
From
Oncology Issues
medscape.com;
The Impact of Managed Care on Oncology Practice
Authors: Lee E. Mortenson, D.P.A., Shelah Leader, Ph.D., Rajiv Mallick, Ph.D., Jamie Young, M.A., James L. Wade III, M.D.
Summary
Results from a 1996 survey of oncologists show that managed care is adversely affecting patients' access to care and practice costs. In general, oncologists report managed care policies affect their clinical decisions and lead them to hesitate to prescribe expensive forms of chemotherapy, hospitalize patients, provide bone marrow transplantation or terminal and follow-up care, or enroll patients on clinical trials. Oncologists also report they must add office staff to deal with the increased administrative hassles that come when working with managed care plans. [Oncology Issues 12(5): 22-27, 1997. Association of Community Cancer Centers] |
