When patient flow the source of income to a physician is controlled by an insurance company, it becomes risky for that physician to place his patients needs first. When physicians become employees of insurance plans they are tempted to place their employer s interests before their patients. Conversely, when physicians are capitated, they must resist the temptation of providing less than optimal care. In a capitation system, physicians are rewarded when they conserve money by rendering less care to a group of patients. The less care given, the greater the reward.
Physicians are honest, ethical people.
Certainly not every doctor is perfect, but in my experience, as a group they are highly principled humans. However, the decision making process is complex, and physicians are influenced by numerous factors. Even when decisions seem straightforward, a medical rarity, subtle pressures like patient desires, malpractice concerns, patient or physician convenience, and reimbursement influence the decision making process. I find that my constant ethical challenge is to keep the extraneous factors from influencing the care given to my patients. Keen awareness of these influences and a concerted effort to be a good physician keep me at peace with myself and my God.