The impact of managed care on dermatology.

The goal of managed care is to find the most effective mix of the factors of production to provide quality care to its members. The aforementioned information on the impact of managed care on dermatology suggests that the future of dermatology need not be bleak. The supply of dermatologists in the nation is far more consistent with the demand of classic MCOs for dermatologists than for almost all other specialties. In addition, any form of health care reform that increases access to health care for the uninsured and underinsured will increase the demand for dermatologic care. Similarly, a well-functioning managed care plan will move to establish the boundary line between skin care by PCPs and dermatologists in a consensual, objective, and mutually respectful process. The attempt to define this boundary will give added impetus to the development of outcomes measurement and management in managed care and serve to advance the interests of all parties concerned, including the patient. A well-defined boundary line between care appropriately rendered by PCPs and that provided by dermatologists will result in dermatologists treating a higher severity of illness--the cases for which dermatologists were trained to treat. The higher level of severity of illness could be associated with a higher level of professional satisfaction. Similarly, capitated arrangements between dermatologists and PCPs create incentives for cooperative education and communication initiatives between both parties to define appropriate ranges of care and referral timing. Where capitated arrangements do not exist, it is also important to define such appropriate ranges of care.(ABSTRACT TRUNCATED AT 250 WORDS)