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—Dr Hensel raises several interesting points.First, he applies our patient-physician alliance in community model to the case we described in our article. We fully agree with the scenario Hensel describes. This is indeed how we would envisage the working of our model. As Hensel implies, third-party payers, especially managed care organizations, are not yet at the point of responding altruistically or indeed with enlightened self-interest to such situations. At the same time, not all physicians are ready to pursue matters as Hensel describes. We need to undertake significant educational efforts to move in the desired direction on both theme fronts.Second, Hensel is correct in stating that managed care organizations are willing to deny payment for expensive procedures, but are not willing to support the time it takes to educate the patient about the appropriate use of such tests. Again, this is an area where mutual education is needed.
Balint JA, Shelton W. The Patient-Physician Relationship: Time to Reimburse What We Preach-Reply. JAMA. 1996;276(1):27. doi:10.1001/jama.1996.03540010029015