ATTITUDES OF US NEUROLOGISTS CONCERNING THE ETHICAL DIMENSIONS OF MANAGED CARE

We surveyed attitudes of US neurologists about the ethical dimensions of managed care by administering a written instrument containing parad igmatic cases portraying conflicts of physicians, patients, and manage d care organizations (MCOs). After each case, we assessed neurologists ' attitudes by asking them their degree of agreement with a series of statements. We found that neurologists (1) generally were willing to f ollow clinical practice guidelines if they were created by medical soc ieties; (2) experienced frequent conflicts of interest or conflicts of obligation in the care of their MCO patients; (3) feared legal ramifi cations of their clinical decisions on MCO patients; (4) were unwillin g to employ deception or gaming to achieve what they perceived to be g ood patient care; (5) believed that their professional prerogatives an d autonomy were under attack by MCOs; and (6) felt that the good of th eir patients should not be sacrificed for the good of society.