Streja and Rabkin,1 by reviewing the managed care clinical records of 519 patients with diabetes over 2 years in north Los Angeles, and by debriefing their 22 attending physicians and the physicians' administrative bosses, have verified famously that those "providers" who best comport their practice style to managed care (the "fast doctors") tend strongly to be slipshod clinicians. But one might query: "Who should have imagined otherwise?"
Steinsmith W. Plunging Clinical Standards Under Managed Care. Arch Intern Med. 1999;159(13):1499. doi: