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Commentary |

Is the Therapeutic Nature of the Patient-Physician Relationship Being Undermined?  A Primary Care Physician's Perspective

William T. Branch Jr, MD
Arch Intern Med. 2000;160(15):2257-2260. doi:10.1001/archinte.160.15.2257.
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SINCE THE advent of managed care, the practice of medicine has changed rapidly in just a few years. From the perspective of a generalist physician, such as myself, major changes include the loss of flexibility in controlling one's practice, the often wholesale transfers of patients from one physician to another as employers switch health plans, the impersonal selection of physicians from a list rather than by personal referral, and the existence of a large percentage of young physicians who are entering practice today as salaried employees of organizations. Just a few years ago, I controlled my own schedule in practice, and could spend as much or as little time as necessary to provide good care. My patients chose me to be their physician and maintained long-term relationships with me. My chief incentive was to satisfy them. I never felt that a third party was involved in this interaction.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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