I read with interest the article by Asch et al1 in the April issue of the Archives; the article attempted to assess the effects of managed care on ophthalmology. I have just moved from southern California primarily because of the effect of managed care on my practice. My practice is limited to pediatric ophthalmology and adult strabismus.
One aspect of the economics of managed care was not addressed in this article. It is interesting to speculate what the economic effect from lost work time is considering the inefficiency of the referral process in managed care. Almost each day some error caused a breakdown in the referral process and precluded at least one patient from being seen after the patient reached my office. We were, therefore, forced to reappoint these people. It was also my impression that this was not an uncommon occurrence in other offices. The fault varied among
Elliott RL. 'Managed' Care Somewhat 'Mangled'?. Arch Ophthalmol. 1997;115(11):1484. doi:10.1001/archopht.1997.01100160654033