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Utilization review, DRGs, and physician autonomy
The Journal of Medical Practice Management : MPM
|February 4, 1987
Summary
Physicians perceive federal healthcare resource control measures, like utilization review and Medicare prospective payment systems, as threats. Understanding these impacts on practice is key for physicians to proactively engage with healthcare policy.
Area of Science:
- Health Services Research
- Medical Policy
- Physician Economics
Background:
- Federal legislation increasingly aims to control scarce healthcare resources.
- Physician responses to utilization review and Medicare prospective payment systems vary.
Purpose of the Study:
- To examine physicians' perceived threats from healthcare resource allocation strategies.
- To analyze physician concerns regarding bureaucratic tensions, income, clinical decision-making, and self-regulation.
Main Methods:
- Qualitative analysis of physician perceptions.
- Examination of physician responses to federal healthcare control measures.
Main Results:
- Physicians perceive significant threats to professional practice from utilization review and prospective payment systems.
- Key areas of concern include bureaucratic interference, income stability, clinical autonomy, and professional self-regulation.
Conclusions:
- Physicians face challenges adapting to federal healthcare resource management.
- A proactive physician stance can mitigate negative impacts and foster constructive engagement with healthcare policy.