In all relationships everyone balances conflicting duties. Where a physician finds himself in a terrible bind, he has some level of duty to notify the patient that he can't order what he'd like to. Gail Grant'82, who also has MPH and MBA degrees from the University of California at Los Angeles, works as a senior research scientist for Value Health Sciences in Santa Monica, Calif., a health services research company that supplies consulting services, information, and disease management programs to managed care organizations, medical groups, health insurance companies, and providers. By shifting the focus to improving quality, lower cost will follow, and 'best care' will be delivered. But medicine can't help but be expensive, says Joseph Shipp'52, a UCSF-Fresno professor of medicine and medical director of the Central California Diabetes Center.
Medical care is costly.
The view that you can make medical care uncostly is not possible. With managed care, which Dr. Shipp calls mangled care, the sworn oath is balanced with great difficulty. He says the ethical problem is absolute once a physician's take-home pay is influenced by the amount of care he gives. Before 1965, medicine was not an especially lucrative profession. That changed when President Lyndon Johnson signed the Medicare bill.