Major issues confronting the practicing dermatologist in the 1990s

Protein issues confront the dermatologic practitioner in this last decade of the twentieth century, including 1) the role of managed care; 2) the decline of direct access to the specialist; 3) malpractice liability and the need for reform; 4) declining reimbursements in the face of escalating practice overhead; and 5) conflict between the individual's right to care and society's ability to subsidize that right. Correcting and improving the American health care system demands a return to the emphasis and values that made that system the envy of the entire world. We must re-emphasize the sanctity of the doctor-patient relationship, halt the incursion upon physician autonomy, and eliminate those third party factors such as insurance companies, bureaucrats, and administrators that accentuate commerce instead of compassion in medicine. It is hoped that by expanding and equalizing the American health care system, it is not made unpalatable and unresponsive to every citizen.