Medical Practice in the Competitive Market

Abstract

Four medical student preceptees were sitting opposite me when my office telephone rang. The daughter of a patient was calling to ask me to write a letter to her father's health plan. I had discovered acute myelogenous leukemia while treating her 54-year-old father for a sprained back, and the physician (and hospital) to whom I had referred him for intensive chemotherapy had told her that they had no contract with the patient's health plan. Consequently, he might have no insurance coverage for the expected six weeks of hospitalization that would determine whether he would live or die.Grimly, I dictated . . .