Physician reactions to the health care revolution. A grief model approach.

The American health care reform revolution has brought about major changes in the practice of medicine. As integral components of the health care system, physicians have felt the full impact of most of these changes. Change often involves losses for those affected, and, in this case, physicians are no exception. Many physicians have experienced losses of financial security, social status, independent clinical decision making and resource utilization, the practice option of independent private practice, hospital governance power, freedom of choice in specialty selection and geographic practice location, physician collegiality, continuity of patient relationships, and autonomy. We use Kübler-Ross' grieving model to help understand physician responses to their losses inherent in health care system reform. The grieving stages of denial, anger, bargaining, depression, and acceptance are applied to these physician responses and suggestions given to help physicians through this grieving process.