Ethics in managed care and pain medicine

The responsibility for ethical behavior in medical care has been described historically as evolving through 3 stages: personal responsibility, profess ional group responsibility, and organizational responsibility. Together the se 3 forms provide a system of accountability that works better than any on e form alone. Today we have added a fourth stage, societal responsibility, in which oversight of managed care practices is maintained by external revi ew organizations. Managed care organizations and their medical directors ca n work with physicians, professional societies and oversight organizations to develop a working healthcare system that protects the ethical rights of individual patients and populations of patients.