Miller R U, Zimmerman D R
J Med Pract Manage. 1987 Summer;3(1):17-21.
The considerable growth of health maintenance organizations is significantly changing the traditional systems under which physicians have historically practiced medicine. Allowable cost reimbursement, fee-for-service payment, and private practice are being confronted with the spread of HMOs and the shift of physicians to capitated payment systems or salaried employment status. The disruption in physicians' work lives has led to a number of collective responses including militant resistance to HMOs, the creation of physician-controlled HMOs, affiliation with union-like mutual benefit organizations, and the establishment of physician labor unions. This paper examines the impact of these changes on physicians and the nature and likely success of the responses being made.
健康维护组织的显著增长正在极大地改变医生长期以来行医的传统体系。允许成本报销、按服务收费支付以及私人执业正面临着健康维护组织的扩张以及医生向按人头付费体系或受薪就业状态的转变。医生工作生活的中断引发了一系列集体反应，包括对健康维护组织的激进抵制、创建由医生控制的健康维护组织、加入类似工会的互助组织以及成立医生工会。本文探讨了这些变化对医生的影响以及所做出反应的性质和可能的成效。
