Ethical Dilemmas in Managed Care for the Practitioner
Those who believe in the cycles of history must be struck by the dramatic upheavals at both the beginning and end of this concluding century that have characterized American medicine. Some particular historical analogies are also in order. The beginning of the twentieth century saw the evolution from the Dark Ages of American medicine as the Flexner Report set needed standards for education and training. By the 1950s, the age of technology, like the Renaissance and later Age of Faith, led to an exuberance of discoveries, treatments and hope that seemed unbounded. But now, as a new century dawns, the Reformation is with us in the form of cost awareness and containment and shows no hope of abating now, or in the near future (Boisaubin, 1994, pp. 1–2).
KeywordsEngland Journal American Medical Association Primary Care Provider Ethical Dilemma Cost Containment
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