Maloccurrence in oculoplastic surgery related to the managed care environment

Conflicts between specialties abound in problems of the periorbita with different specialties claiming expertise in this area. These conflicts include both the diagnosis and the treatment of oculoplastic problems. Cases are presented in which such conflicts have arisen leading to less than optimal care for the patients. Engendering these conflicts are the Managed Care fiats of both insurance companies and hospital territorial conflicts. Ideas are presented for the ethical resolution of both the physician conflicts and for the recognition that managed care induced conflicts lead ultimately to less than optimal care.