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—Dr Coggan provides insight into the operations of one for-profit health plan, with a focus on financial accountability and an approach to decision-making that has not been characteristic of the academic setting. While we agree with Dr Coggan that it is not appropriate to expect managed care organizations to assume responsibility for medical education, we believe that they are stakeholders in the system. Together with medical schools and teaching hospitals, managed care organizations have a vested interest in shaping the Knowledge, skills, and attitudes of the next generation of physicians. All will benefit if physicians are competent and well educated for the health care system in which they will participate. The challenge for medical education is to work with managed care, to penetrate the barrier of "us" vs "them," and to achieve consensus on the preparation of young physicians. This includes finding ways to provide educational experiences in the most
Barzansky B, Veloski J, Nash DB, Bastacky S, Stevens DP. Medical Education and Marketplace Competition-Reply. JAMA. 1997;277(13):1037. doi:10.1001/jama.1997.03540370027027