Morreim E H
College of Medicine, University of Tennessee, Memphis 38163, USA.
Am J Manag Care. 1997 Jan;3(1):35-43.
As managed care becomes more prevalent in the United States, concerns have arisen over the business practices of managed care companies. A particular concern is whether patients should be made aware of the financial incentives and treatment limits of their healthcare plan. At present, managed care organizations are not legally required to make such disclosures. However, such disclosures would be advisable for reasons of ethical fidelity, contractual clarity, and practical prudence. Physicians themselves may also have a fiduciary responsibility to discuss incentives and limits with their patients. Once the decision to disclose has been made, the managed care organization must draft a document that explains, clearly and honestly, limits of care in the plan and physician incentives that might restrict the care a patient receives.
随着管理式医疗在美国变得越来越普遍，人们对管理式医疗公司的商业行为产生了担忧。一个特别令人担忧的问题是，患者是否应该了解其医疗保健计划的经济激励措施和治疗限制。目前，法律并没有要求管理式医疗组织进行此类披露。然而，出于道德忠诚、合同清晰和实际审慎的原因，进行此类披露是明智的。医生自身可能也有信托责任与患者讨论激励措施和限制。一旦做出披露的决定，管理式医疗组织必须起草一份文件，清晰、诚实地解释计划中的护理限制以及可能限制患者接受护理的医生激励措施。
