This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fye, W. B. Search for Related Content PubMed PubMed Citation Articles by Fye, W. B.

(Circulation. 1998;97:1895-1896.)
© 1998 American Heart Association, Inc.

Editorials

Managed Care and Patients With Cardiovascular Disease

W. Bruce Fye, MD, MA

From the Cardiology Department, Marshfield Clinic, Marshfield, Wis and University of Wisconsin.

Correspondence to W. Bruce Fye, MD, MA, Medical Director, Marshfield Heart Care, Marshfield Clinic, 1000 N Oak Ave, Marshfield, WI 54449. E-mail fyew@mfldclin.edu

Key Words: Editorials • managed care programs • patients

Physicians and other healthcare professionals must become more active advocates for patients in this new era of for-profit managed care. We must, for example, add our voices to those of organizations such as the AHA and the ACC that speak out on behalf of persons with cardiovascular disease and institutions that advance knowledge through education and research.^{1 2}

During the early 1990s, for-profit managed care swept over the American landscape like a flood, washing away medical traditions and disrupting doctor-patient relationships. By now, the fast-moving currents of managed care have reached virtually every heart specialist and every cardiac patient in the nation. The unique doctor-patient relationship, built on a centuries-old foundation of altruism and trust, has been undermined.³ Individual patients seeking personalized care are sometimes pushed around like pawns on a chessboard. Meanwhile, doctors sometimes confront hastily constructed but effective barriers that disrupt or destroy long-standing relationships with their patients and their peers.

Most readers of Circulation would agree that American cardiology is a brilliant achievement based on the integration of research advances, technological and pharmaceutical innovations, and highly trained clinicians.⁴ Heart patients are living longer and better lives as a result of this fertile union and enhanced emphasis on risk factor reduction. Not everyone shares this optimistic view, however, especially those managed care executives whose main goal is to spend less on health care in order to reward their investors and attract new business.

The most aggressive leaders of for-profit managed care often seem unconcerned with the ideals and institutions . . . [Full Text of this Article]

This article has been cited by other articles:

				W. B. Fye Introduction: the origins and implications of a growing shortage of cardiologists J. Am. Coll. Cardiol., July 21, 2004; 44(2): 221 - 232. [Abstract] [Full Text] [PDF]

				D. J. Kereiakes and J. T. Willerson The United States Cardiovascular Care Deficit Circulation, February 24, 2004; 109(7): 821 - 823. [Full Text] [PDF]

				E. F. Philbin, H. F. C. Weil, T. A. Erb, and P. L. Jenkins Cardiology or Primary Care for Heart Failure in the Community Setting: Process of Care and Clinical Outcomes Chest, August 1, 1999; 116(2): 346 - 354. [Abstract] [Full Text] [PDF]