Correspondence
Some More Costs of Managed Care
N Engl J Med 1993; 328:736-737March 11, 1993
- Article
To the Editor:
I wish to comment on an interesting new phenomenon, the extraordinary acceleration in the cost of continuing education for those engaged in managed care. After a 40-year medical career, 31 in internal medicine, 6 in medical education, and the most recent 3 in managed care, I hope I can report on this new trend fairly and objectively.
If a total of 50 hours of continuing education is required annually for licensure (as in Ohio) and for updating an internist's medical knowledge, I could make a good start on obtaining these credit hours by taking a three-day course held in Florida, providing 18 credit hours in category 1 of the Physician's Recognition Award of the American Medical Association. The registration fee is $175. Now, putting on my other hat as medical director of a preferred provider organization, I will soon learn how to “achieve quality network management.” The 1 1/2-day course, including one luncheon, costs $1095.
The price of my subscription to the Journal is $96 for 52 issues. A subscription to the Report on Medical Guidelines and Outcomes Research is $495 for 24 issues, each of which is six to eight pages long.
Registration for the venerable American College of Physicians' annual meeting, to be held for four days in April 1993, costs from $110 to $435, depending on the affiliation of the attendee. Registration for a 1 1/2-day seminar entitled “Putting Theory into Practice: How Providers and Payers Use Medical Guidelines and Outcomes Research” costs $595. A 2 1/2-day seminar entitled “Clinical Care of the AIDS Patient” and held in December 1992 cost from $250 to $295, and one on “Depression: Medical Perspectives, Diagnosis and Management,” which will be held from 8 a.m. to 5 p.m. on March 13, 1993, costs $60 to $95. In contrast, a meeting entitled “New Information Technology in Health Care Data Management” will be held in Philadelphia over a 1 1/2-day period in March and will cost $1095, including one luncheon; the brochure for this meeting contains a caveat in small print to the effect that the “program schedule [is] subject to change as warranted by market circumstances.”
Just who is making the sacrifices necessary to control costs? Is it the utilization reviewer, the case manager, the outcomes analyst, the newsletter publisher, or the seminar events coordinator, or does it still devolve on the provider of services, the managed, the user, the analyzed, the reviewed? Let the reader decide.
William D. Loeser, M.D.
464 Arbor Circle, Youngstown, OH 44505- Citing Articles (1)
Citing Articles
1
B. Carpenter, J. Dave. (2004) Disclosing a Dementia Diagnosis: A Review of Opinion and Practice, and a Proposed Research Agenda. The Gerontologist 44:2, 149-158
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