Implementing economic principles in medicine while maintaining medical professionalism

Abstract

Introduction: Various forms of the managed-care concept have been conceived to reconcile the medical professionalism with necessary cost-cutting measures in health-care provision. A plethora of bureaucratic regulations and required paperwork result in increasing resignation among physicians and withdrawal from patient care. Options: An appropriate option would be to focus not on structures and processes, but primarily on patient-related outcomes. We describe suitable options, their possible consequences, possible developments, and conclusions that can be derived. Prognoses: Neglecting a trustful doctor-patient relationship risks forfeiting fundamental parts of essential health-care provision. Patients’ preferences have to be respected, while unnecessary risks and expenses have to be avoided. Further development: At least 12 dimensions influence the balance between medical professionalism and economics. The success of our health-care systems will depend on the best possible mix. Conclusion: An optimal health-care system is characterized neither by the structures nor processes of health-care delivery, but by the quality of patient outcomes. Our patients must be involved in the description of the goals they want to achieve so that physicians can select the best possible ways to attain these goals.