They might be restricted in the amount of time they can spend with each patient, forcing abrupt and perhaps incomplete doctor-patient communication. Given the level of public distrust of managed care organizations, doctors might also encounter patients who are guarded and suspicious or who may exaggerate symptoms in an effort to secure a greater level of care. Yes, says Illingworth. In addition, she points out, managed care companies 'use promotional materials that promise subscribers wonderful health care with a trusting, caring physician' and through their association with physicians, 'they piggyback' on that trust. The result was managed care systems that emphasized preventive care and slashed redundant or unnecessary procedures.
Big corporations wield enormous influence with managed care companies.
They set the price they're willing to pay, and in doing so, they decide what benefits will be offered to their employees. Whether employers should even be in the business of choosing and paying for health care is another debate altogether, and one worth having, says Illingworth. They have to keep the promises implied by their role as proxies. That is, it takes into account the ripple effect of certain actions-so an HMO manager, for instance, might consider how doctors and patients fare with certain decisions, not just what increases company profit.