Physicians as Gatekeepers

Abstract

There is sharp contention between cost-ignoring and cost-constrained views of medical practice — and both positions have adherents among physicians.Levinsky argues the traditional view: "Physicians are required to do everything that they believe may benefit each patient without regard to costs or other societal considerations.... When practicing medicine, doctors cannot serve two masters.... The doctor's master must be the patient." ¹ Hiatt adds that "it is essential that society protect [physicians] from conflicts in this realm."² On the other hand, Eddy asserts that the rising costs of medical care are profoundly changing the requirements of medical decision making. In his . . .