Physicians Train Their Eyes on the Bottom Line

THE VITALS Are physicians kidding themselves when they think that creating their own risk-bearing networks and HMOs will allow them to regain the clinical control they've relinquished over the past 10 years? How much are their good intentions compromised by the need to operate as a business, and live within a budget, in the competitive health care marketplace? And finally, when physicians form organizations and assume greater financial risk, are they delivering a higher quality of care than traditional insurers and managed care companies provide? The answers to these questions are largely unanswered, thanks to the relative youth of the phenomenon. But physicians who hope to avoid financially influenced decision-making and clinical oversight by joining doctor-run organizations are in for a disappointment, say network leaders and outside experts. By Christine Kilgore. Early this year, Allan Weisshar resigned from the doctor-owned and doctor-run network that, just four-and-a-half years ago, he chose to join because all the doctors involved had "outstanding reputations.". A new contract between the California pediatrician and network management ...

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