Managed Care in Neurorehabilitation

The collision between the practice and the business of medicine has spawned a sys tem of health care termed managed care Although physicians recognize the circum stances that fostered the appearance of these organizations, they generally are not en amored of the restrictions in their autonomy when diagnostic tests and therapeutic interventions fall out of the “norm.” They experience a decline in their practice economies and are aware of dollars taken seemingly without tangible benefit to their patients. Overall, they dislike their placement between contractual obligations with managed care organizations and their ability to practice “quality medicine.” Physicians also recognize the some of the benefits managed care can provide. The escalating costs of medicine have created a need to identify affordable sources of health care that managed care organizations may provide. The security and flexibility that em ployment versus practice ownership brings may be a relief to the physician who wishes to focus only on clinical duties. Some of these organizations can assimilate large amounts of clinical data and improve the delivery and quality of health care. However, managed care is a complex concept and needs to be more fully understood by the physician as he attempts to manage both the clinical and the business aspects of his practice.