Medication managed care

The other corporate influence is that of managed care. The limits on approval, duration, or nature of therapeutic contact, or covered services themselves have turned prescription writing into one of the only reliable and reimbursable acts therapists can perform on behalf of their patients and their livelihood. The 15-minute medication check that has been established as the industry standard of care reduces the therapeutic alliance to an encounter between a prescriber, or... 

Other factors, such as the availability (or lack of availability) of community resources or the ingress of managed care policies that shape clinical behavior, might be invoked to explain possible changes in prescribing and help-seeking behaviors. In addition, studies of physician attitudes as well as parent and family attitudes about medications use and usefulness are... 

Today s healthcare policy-makers, including government officials, health insurance companies and managed-care organizations, are faced with the reality of limited resources for healthcare and the knowledge that much medical care is of uncertain value. The value of vitamin E therapy in Alzheimer s disease, for example, is still unclear, but some physicians have recommended it for years without any real measures of its effect on the disease. 

There are three reasons why it is essential for clinicians to be familiar with this class of products. First, many OTC medications are effective in treating common ailments, and it is important to be able to help the patient select a safe, effective product. Because managed care practices encourage clinicians to limit the cost of drugs they prescribe, many will begin to recommend effective OTC treatments to their patients, since these drugs are rarely paid for by the insurance plan. (See Table... 

The next rung up the freebie ladder is some sort of simple food in the doctor s office. It can be a box of Dunkin Donuts every month for a New York City pediatrician, or Chinese food and deli sandwiches, also monthly, for the staff of 10 at Dr. Robbins s office. If it s lunch, the reps will generally stay for an hour to talk about their products. (However, there s no guarantee the doctor will be there to listen.) With all the clerical workers that physicians have had to hire to handle their managed care paperwork, the lunchtime crowd can easily reach 25 or 40. If I had my druthers, I would only buy lunch for the doctors and nurses, Webber grumbles. But I m never going to say no to anybody who walks through the door. I think it s rude to do the [medical] staff and leave the receptionist at the front. ... 

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