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October 1996

Fatal Flaw of Stanton's Doomsday Rx

Author Affiliations

Oxnard Dermatology Medical Group 1150 N Ventura Rd Oxnard, CA 93030-3837

Arch Dermatol. 1996;132(10):1247. doi:10.1001/archderm.1996.03890340113022

This letter is in response to the April 1996 Archives article by Stanton.1

With any prescription, a conscientious physician must consider side effects. In Stanton's article, entitled "Rx: Capitation... a Bitter Pill for the Near Future," he discounts 2 serious adverse effects: consumer harm and physician dissatisfaction. When someone is intolerant of a prescription, both the suffering patient and the physician in charge must be responsible for correcting the situation. Capitation provides only 3 things: It temporarily assuages the financial insecurities of physicians. It offers inexpensive health care for well people only. It reinforces P. T. Barnum's adage about the American public ("There's a sucker born every minute").

Stanton's acceptance of managed care and capitation as "a natural business consequence" is as far from inevitable as savvy consumers and true physicians allow it to be. Perhaps Stanton intended to incite dermatologists. Hopefully, that happened, but his indictment

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