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Editor's Correspondence
September 11, 2000

Cost-Control Arrangements and Misdirected Loyalty

Author Affiliations

Copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2000

Arch Intern Med. 2000;160(16):2546. doi:

I concur with the interesting article by Sulmasy et al1 regarding cost-control arrangements that are perceived as ethically objectionable by physicians. Having practiced primary care medicine for 20 years, I have witnessed the change in medicine as loyalty to managed care companies for cost containment has taken precedence over loyalty to patients. But there is more.

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