Managed care: Jekyll or Hyde?

Article Abstract:

Physicians must assume a leadership role to preserve the integrity of the physician-patient relationship in the managed care era of the 1990s. A report issued by the American Medical Association's Council on Ethical and Judicial Affairs in 1994 addressed ethical issues in managed care. The report failed to acknowledge physicians' role in resource allocations or the inherent conflict between the needs of an individual patient and the needs of patients as a whole. Specifics must augment the council's warning against 'bedside rationing' of health care resources. Physicians must acknowledge that resource allocation decisions are being made and 'bedside rationing' is almost unavoidable. Ethical principles may provide a framework for responsible, patient-oriented allocation decisions. Physician leadership is needed to preserve the positive aspects of managed care, to eliminate features that jeopardize patient well-being, and to promote a system that emphasizes health outcome over financial rewards.

Editorial, Models, Ethical aspects, Managed care plans (Medical care), Resource allocation

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The mammalian medical center for the 21st century

Article Abstract:

The next generation of medical education centers are beginning to appear now and their emphasis is on the training of highly skilled primary care physicians. Previous models of medical education, such as that embodied by the Johns Hopkins University, focused on academics. They produced well-trained, research-oriented physicians. The research conducted at these academic institutions improved the health of citizens of the 20th century. However, the problems of the 21st century are different and require a different type of doctor. The major factors influencing changes in the medical education system are cost and scarcity. Most other developed nations train the majority of their doctors in primary care. Most other nations also spend a lower percentage of their gross national product on health care than the US does. The new medical centers will emphasize ambulatory care, disease prevention and health promotion. There will also be a greater emphasis on public health issues.

Education, Physicians (General practice), General practitioners

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Medical education in modern China

Article Abstract:

The secondary medical schools in China which include general education in language, literature, mathematics and science as well as specific vocational training in medicine are discussed.

China, Forecasts, trends, outlooks, Reports, Market trend/market analysis

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