MANAGED CARE - NEW CHALLENGES, NEW ROLES FOR THE PRIMARY-CARE PHYSICIAN .2. DISCUSSION

Managed care is revolutionizing health care, according to panelists in this roundtable discussion. Primary care physicians need to see patie nt care not as episodic but as a total, preventive package. In managed care, physicians hire nonphysician extenders for patient screening an d function as a manager and consultant to an interdisciplinary team th at extends beyond the four walls of the office practice. Patients need to know that primary care physicians can handle most of their problem s; the specialist should be referred cases that are complicated and re quire procedures or second opinions. Outcome studies in managed cal-e are lacking in important areas of geriatric medicine, such as treatmen t of psychiatric illnesses and Alzheimer's disease.