Physicians' perceptions of managed care

The active physician members of the Broward County Medical Association were sent a mail survey requesting information about their perceptions of and experiences with the managed care industry. Currently, as gatekeepers, physicians are the implement of the managed care system. From an organizational perspective, the role of implementer is a critical position and physicians are directly affected by and affect the operations of managed care as a healthcare delivery system. Even though managed care has the beneficial aspects of controlling healthcare costs and an emphasis on preventive care, it still appears that physicians perceive the managed care industry quite negatively. Because managed care does not appear to be a transitory phenomenon and is rapidly expanding in both the private and public sectors, it is important to identify the aspects of the managed care industry at are associated with the negative perceptions of physicians. The study focused on such topics as changes in the physician's level of satisfaction with both patients and practice that have been caused by managed care, the financial incentives used by MCOs to limit treatment and the ethical conflicts that these incentives can create for physicians, whether physicians need to participate in managed care to maintain their financial viability, the presence of gag clauses in physician contracts, the physician-patient relationship and how it is affected by the managed care environment, patient continuity of care, whether managed care should be regulated by the government, whether physicians have been penalized by or involuntarily disenrolled from MCOs, and whether physicians played by managed care rules or "game the system" or bent managed care rules to improve patient outcomes. This study also reviewed the professional and demographic variables that may influence differences between perceptions and experiences. The results indicate that there are few between group differences based on gender, practice location and years in practice. There are more differences based on race, type of practice, type of medical training, location of medical training, and percentage of practice income based on managed tare contracts. There appear to be many significant between group differences based on percentage of patients in managed care and number of managed care affiliations.