Managed Care

Managed care looks into distribution of scarce resources while putting into consideration ethical factors relating to physician-patient relationships.

Managed care looks into distribution of scarce resources while putting into consideration ethical factors relating to physician-patient relationships. These aspects are addressed by an organization at a fee. Managed care delivery systems aim at providing the best medical care not because they are profitable but because it is the right thing to do. Ethical values come first when offering this service, despite the fact that it is a business that needs to achieve its financial goals.

In an effort to increase the managed care delivery service efficiency, the need to involve the community cannot be over-emphasized. The communities’ combined effort enables the organization to provide medical care benefits to individuals at lower costs. The idea is to bring more forces together to raise the required finances so as to offer proper medical care over a long-term period.

It is important that proper medical care is available to all people at all times. Besides gathering finances and observing ethical values, accessibility is also important. The organization’s services should reach out to the majority. The basic idea behind establishment of managed care organizations is to distribute care, manage within the budget and still offer the best care. Therefore, MCOs balance the process involved in decision making at the clinical level and financial resources. This ensures that the best services are provided at an affordable price, which guarantees that the business does not collapse.

Physicians Dual Function

Under the managed care organizations, physicians have been identified to serve two purposes and thus the dual function. They advise on finances and build patients’ confidence in the system. Managed care organizations may have their own physicians or may team-up with a group of physicians who act as referrals from the organization.

Physicians offer medical care to patients directly. The managed care organizations act only as a link between a physician and a patient. The sole purpose of physicians is to provide appropriate care and ensure that they can be accessed easily by majority of individuals registered for managed care. They also have to uphold ethical values when relating to the patients so as to offer the best services. Not only do they uphold ethical values and professionalism, but also balance aspects. With a business mind, they are able to advise patients on medical benefits and finances. They advocate for suitable medical packages that will offer the best benefits at lower cost.

With disregard of the traditional means of receiving care, where the patient pays before receiving the service, physicians have been able to ration the available resources out. This has helped to manage the available resources and prevent wastage and misuse of them. Managed care organizations ensure that they treat all the patients with equality. These factors help the patients build their trust in the managed care as they are assured that the physician is experienced in the given line of expertise.

Physician-Patient Concerns

The physician-patient relationship under managed care organizations weighs the necessity of a resource so that they provide it to the patient that needs it most. While looking at it from that perspective, the concern of not being able to justify this action raises an ethical issue. Despite the scarcity of resources, it becomes a difficult issue to determine the mode of distribution that will serve all the patients.

While the physician helps the patients manage their medical benefits with respect to the attached financial risks, it is difficult to balance business and ethics at this point. It is morally right to consider one’s health as opposed to one’s finances yet without finances it is difficult to access these services. The question of morality over making profits in the business is debatable.

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