Thanks, Dr Eisenberg! I happened to be reading the ARCHIVES last Thanksgiving Eve after hospital rounds and saw his fabulous editorial.1 I congratulate him for the clear insight and honest overview of the present managed care system vs the old, virtually extinct system.
I thank Eisenberg because it takes courage as a Harvard academician to confront reality and state things as they are. I believe, following his text, that as Socrates said, most of us are treating patients the way slave doctors once treated slave patients: rushing, careless, and looking for the best way to profit in a hypocritical way. I still try to deliver care as I was taught to do in medical school and later during my residency. Capitation should disappear from the face of this world, and we should stand together for what we were taught: to care for the patient, not for the paycheck. It is a shameful state of affairs when physicians no longer want to see certain patients because it will mean less reimbursement or when nurse practitioners are asked to see certain patients because physicians love the uncomplicated sore throat more than the challenging patient in the intensive care unit who belongs to an HMO.