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February 1997

Managed Care

Author Affiliations

Department of Neurology New York Medical College 325 S Highland Ave Briarcliff, NY 10510

Arch Neurol. 1997;54(2):119-120. doi:10.1001/archneur.1997.00550140007004

This letter is in response to the excellent set of articles on managed care, which appeared in the September 1996 issue of the Archives. Marketdriven health care has significantly affected the neurologist. Areas regarding medical-legal exposure and aberrant peer review were not addressed. Thus, I believe this letter will be of major significance to our colleagues.

The Archives is to be congratulated for the comprehensive and provocative special article relating to the neurologist and managed care. Unfortunately, an important issue not discussed is the physician's legal exposure when third-party payers impose limitations on care. Also omitted was a discussion of aberrant peer review patterns.

We are witnessing a historic transformation in the American health care system, and managed care has targeted hospitals and specialists who use expensive technologies as the principal focus for achieving cost reduction. Neurologists should pause to consider their legal exposure when managed care dictates "not medically

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