The quality of physician-patient communication affects important healt
h care outcomes, Managed care presents a number of challenges to physi
cian-patient communication, including shorter visits, decreased contin
uity, and lower levels of trust. Good communication skills can help ph
ysicians create and maintain healthy relationships with patients in th
e face of these challenges, We describe 5 communication dilemmas that
are common in managed care and review possible solutions suggested by
recent literature on physician-patient communication, We also describe
ways that managed care plans can promote more effective communication
between physicians and patients.