POSTTREATMENT FOLLOW-UP OF RADIATION ONCOLOGY PATIENTS IN A MANAGED CARE ENVIRONMENT

Purpose: Health care delivery in the United States is in the midst of a structural revolution called managed care. Demands for cost control within the managed care environment force radiation oncologists to def end the need and obligation to follow their patients. Methods and Mate rials: We have analyzed this follow-up requirement from six potential justifications: patient care, medical-legal, quality assurance, outcom e measurement, cost, and improvement of care. Results: Practical recom mendations for discussing the need for follow-up with the medical dire ctors and primary care physicians of managed care entities are given, Follow-up without valid documentation of benefit is hard to justify in this era of managed care. Conclusions: Collaborative follow-up betwee n the referring physician, the treating radiation oncologist, and the other oncologic specialists will allow for outcome measurement and imp rovement in practice without driving up cost or exposing the patient t o undue risk.