Professionalism reconsidered: Physician payment in a small-practice environment

Health Affairs

Volumn 23, Issue 6, 2004, Pages 36-47

  Cunningham, Robert ^a  

^a Health Affairs ^*

Author keywords

[No Author keywords available]

Indexed keywords

CLINICAL PRACTICE; HEALTH CARE; HEALTH CARE ORGANIZATION; HEALTH CARE PLANNING; HEALTH INSURANCE; HEALTH SERVICE; HUMAN; MEDICAID; MEDICAL DECISION MAKING; MEDICAL FEE; MEDICAL PROFESSION; MEDICARE; PHYSICIAN; PROFESSIONAL PRACTICE; REVIEW;

HUMANS; MANAGED COMPETITION; MEDICARE; PHYSICIAN'S PRACTICE PATTERNS; PHYSICIAN'S ROLE; PRACTICE MANAGEMENT, MEDICAL; PROFESSIONAL COMPETENCE; REIMBURSEMENT MECHANISMS; UNITED STATES;

EID: 8844255515     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.23.6.36     Document Type: Review

References (38)

1. R. Cunningham and R.M. Cunningham, The Blues: A History of the Blue Cross and Blue Shield System (DeKalb: Northern Illinois University Press, 1997), chapters 2-4.
2. See "Consumer-Directed Doctoring: The Doctor Is In, Even If Insurance Is Out," hearings of the congressional Joint Economic Committee, 28 April 2004, jec.senate.gov/index.cfm?FuseAction=Hearings. Hearing&Hearing_ID=76 (17 August 2004).
3. E. Freidson, Professionalism: The Third Logic (Chicago: University of Chicago Press, 2001), 197-222.
4. E. Freidson, "Professionalism and Institutional Ethics, 1999," in The American Medical Ethics Revolution, ed. R. Baker et al. (Baltimore: Johns Hopkins University Press, 1999); and K.J. Arrow, "Reflections on the Reflections," Journal of Health Politics, Policy and Law 26, no. 5 (2001): 1197-1203.
5. E. Freidson, "Professionalism and Institutional Ethics, 1999," in The American Medical Ethics Revolution, ed. R. Baker et al. (Baltimore: Johns Hopkins University Press, 1999); and K.J. Arrow, "Reflections on the Reflections," Journal of Health Politics, Policy and Law 26, no. 5 (2001): 1197-1203.
6. Freidson, "Professionalism"; and K.J. Arrow, "Uncertainty and the Welfare Economics of Medical Care," American Economic Review 53, no. 5 (1963): 941-973 (republished in Journal of Health Politics, Policy and Law 26, no. 5 [2001]: 851-883).
7. Freidson, "Professionalism"; and K.J. Arrow, "Uncertainty and the Welfare Economics of Medical Care," American Economic Review 53, no. 5 (1963): 941-973 (republished in Journal of Health Politics, Policy and Law 26, no. 5 [2001]: 851-883).
8. M.D. Cabana et al., "Why Don't Physicians Follow Clinical Practice Guidelines?" Journal of the American Medical Association 282, no. 15 (1999): 1458-1465.
9. T.P. Hofer et al., "The Unreliability of Individual Physician 'Report Cards' for Assessing the Costs and Quality of Care of a Chronic Disease," Journal of the American Medical Association 281, no. 22 (1999): 2098-2105.
10. L. Casalino et al., "External Incentives, Information Technology, and Organized Processes to Improve Health Care Quality for Patients with Chronic Diseases," Journal of the American Medical Association 289, no. 4 (2003): 434-441.
11. L.P. Casalino et al., "Benefits of and Barriers to Large Medical Group Practice in the United States," Archives of Internal Medicine 163, no. 16 (2003): 1958-1964.
12. D.K. Cherry, C.W. Burt, and D.A. Woodwell, "National Ambulatory Medical Care Survey: 2001 Survey," Advance Data from Vital and Health Statistics no. 336, 11 August 2003, www.cdc.gov/nchs/data/ad/ad337.pdf (1 March 2004).
13. Casalino, "Benefits of and Barriers to Large Medical Group Practice."
14. Lawrence Casalino, interview, 17 January 2004.
15. B.E. Landon et al., "Physician Clinical Performance Assessment: Prospects and Barriers," Journal of the American Medical Association 290, no. 9 (2003): 1183-1189.
16. L. Landro, "Doctor 'Scorecards' Are Proposed in a Health-Care Quality Drive," Wall Street Journal, 25 March 2004.
17. Donald Berwick, interview, 18 December 2003.
18. Casalino interview.
19. Jeff Kamil, interview, 18 February 2004; and "Blue Cross of California's PPO Physician Quality and Incentive Program (PQIP)" (corporate document).
20. Jeff Kamil, interview, 18 February 2004; and "Blue Cross of California's PPO Physician Quality and Incentive Program (PQIP)" (corporate document).
21. Kamil interview.
22. François de Brantes, interview, 16 March 2004. See also, "For Prospective Purchasers," on the BTE Web site, www.bridgestoexcellence.org/ bte/newpurchaser/index.htm (17 August 2004).
23. François de Brantes, interview, 16 March 2004. See also, "For Prospective Purchasers," on the BTE Web site, www.bridgestoexcellence.org/ bte/newpurchaser/index.htm (17 August 2004).
24. De Brantes interview; and "Overview," www.bridgestoexcellence. org/bte/pdf/overview.pdf (17 August 2004).
25. De Brantes interview; and "Overview," www.bridgestoexcellence. org/bte/pdf/overview.pdf (17 August 2004).
26. Kamil interview.
27. R.H. Miller and I. Sim, "Physicians' Use of Electronic Medical Records: Barriers and Solutions," Health Affairs 23, no. 2 (2004): 116-126.
28. David Kibbe, interview, 11 March 2004.
29. Stuart Guterman, interview, 5 March 2004.
30. L.M. Nichols, "Are Market Forces Strong Enough? Confidence Is Waning" (conference transcript), 12 March 2004, www.hschange.org/CONTENT/ 668/?id_conf=16 (17 August 2004); and L.M. Nichols et al., "Are Market Forces Strong Enough to Deliver Efficient Health Care Systems? Confidence Is Waning," Health Affairs 23, no. 2 (2004): 8-21.
31. L.M. Nichols, "Are Market Forces Strong Enough? Confidence Is Waning" (conference transcript), 12 March 2004, www.hschange.org/CONTENT/ 668/?id_conf=16 (17 August 2004); and L.M. Nichols et al., "Are Market Forces Strong Enough to Deliver Efficient Health Care Systems? Confidence Is Waning," Health Affairs 23, no. 2 (2004): 8-21.
32. L.D. Schaeffer, "How Health Plans Can Help Reshape Health Care," speech at American Enterprise Institute, Washington, D.C., 6 April 2004 (author's notes).
33. J.C. Robinson, "From Managed Care to Consumer Health Insurance: The Fall and Rise of Aetna," Health Affairs 23, no. 2 (2004): 43-55; and J.C. Robinson and J.M. Yegian, "Medical Management after Managed Care," Health Affairs, 19 May 2004, content.healthaffairs.org/cgi/content/abstract/ hlthaff.w4.269 (17 August 2004).
34. J.C. Robinson, "From Managed Care to Consumer Health Insurance: The Fall and Rise of Aetna," Health Affairs 23, no. 2 (2004): 43-55; and J.C. Robinson and J.M. Yegian, "Medical Management after Managed Care," Health Affairs, 19 May 2004, content.healthaffairs.org/cgi/content/abstract/ hlthaff.w4.269 (17 August 2004).
35. Cunningham and Cunningham, The Blues, chapters 1-5; and L.S. Reed, Blue Cross and Medical Service Plans (Washington: Federal Security Agency, 1947), 169-181.
36. Cunningham and Cunningham, The Blues, chapters 1-5; and L.S. Reed, Blue Cross and Medical Service Plans (Washington: Federal Security Agency, 1947), 169-181.
37. P.C. Smith and N. York, "Quality Incentives: The Case of U.K. General Practitioners," Health Affairs 23, no. 3 (2004): 112-118.
38. R. Cunningham, "Medicare Panel Ponders Tight Congressional Control of HCFA," Medicine and Health Perspectives, 15 June 1998, 3-4.