Johnathon S. Ross, MD
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Ross JS. Physicians and Joint Negotiations. Ann Intern Med. 2002;136:710. doi: 10.7326/0003-4819-136-9-200205070-00022
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Published: Ann Intern Med. 2002;136(9):710.
TO THE EDITOR:
The ACP–ASIM position paper on joint negotiations (1) fails to address a key question: Who should be the negotiator for our patients? The critical relationship is between patients and physicians. Physicians should negotiate with patients, not with insurers. Of course, we cannot negotiate our fees one patient at a time. Health care has changed. The community must share the costs of medical care to make new, beneficial technologies affordable; hence the need for an insurance mechanism. For-profit insurance corporations have taken on part of this community role, but their legal and fiduciary duty is not to patients but to stockholders. Should insurers take the place of our patients at the negotiating table? Is this done with the consent of our patients? Our professional, ethical, and moral obligations are to our patients, and this will temper the tone and quality of any negotiations. To protect patients' interests, any negotiations between insurers and physicians should be open and publicly accountable. It would probably be wise to include impartial patient representatives in any negotiations as well.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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