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Books, Journals, New Media
March 25, 1998

Parents With Cancer

JAMA. 1998;279(12):913. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-12-jbk0325

In Reply.—Dr Dedo touches on the evils of utilization review, of lawyers, and of medical directors of managed care companies. The purpose of my Commentary was not to debate the merits of the legal system, the qualifications of medical directors of managed care organizations, or the efficiency and effectiveness of utilization review in improving quality of care. Rather, my purpose was to suggest that the reason we have witnessed these fundamental changes in the way we practice medicine is that the fee-for-service system was not perceived to be producing sufficient value for the money invested in it. Literally hundreds of studies have documented that there were wide and unacceptable variations in the level of quality care and that the mean level of quality of care provided to the American people was not what was desired by them or by their physicians.