Schuch R J, Levy J A
J Med Pract Manage. 1986 Summer;2(1):13-8.
Utilization review and the current Medicare prospective payment system are part of a continuum of Federal legislation aimed at controlling scarce health care resources. Physicians have met these attempts to establish standards of utilization and fiscal control with varying levels of cooperation and resistance. This paper examines the physician's perceived threat to professional practice that these allocation strategies represent. The paper addresses four major areas of concern: bureaucratic tensions; income; clinical decision-making; and self-regulation. The paper ends by discussing the benefits for physicians in taking a proactive stance toward these measures.
利用审查和当前的医疗保险预期支付系统是旨在控制稀缺医疗资源的一系列联邦立法的一部分。医生们对这些旨在确立利用标准和财政控制的尝试，表现出了不同程度的合作与抵制。本文探讨了这些分配策略对医生职业实践所构成的可感知威胁。文章讨论了四个主要关切领域：官僚紧张关系；收入；临床决策；以及自我监管。文章最后讨论了医生积极应对这些措施所带来的益处。
