Promisekeeping: an institutional ethos for healthcare today

The relationship between a physician and a patient, which survived unchanged for decades--indeed centuries--has in recent years undergone a serious change due to the advent of managed care. Controlling costs and maximizing profits are now as equally important as medical concerns, and ethical, econom...

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Bibliographic Details
Published in:Frontiers of health services management 1996, Vol.13 (2), p.5-34
Main Author: Thomasma, D C
Format: Article
Language:English
Subjects:
Caregivers
Conflicts of interest
Cost Control
Decision making
Deductibles and Coinsurance
Ethics
Ethics, Institutional
Executives
Health administration
Health care delivery
Health care industry
Health Facility Administrators - standards
Managed care
Managed Care Programs - standards
Medical ethics
Patient Participation
Patients
Physician patient relationships
Physician-Patient Relations
Politics
Principles
Professional Autonomy
Quality of Life
Social Justice
Social Responsibility
Social Values
Truth Disclosure
United States
Values
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Summary:The relationship between a physician and a patient, which survived unchanged for decades--indeed centuries--has in recent years undergone a serious change due to the advent of managed care. Controlling costs and maximizing profits are now as equally important as medical concerns, and ethical, economic, and political issues have forever changed the way physicians perform their duties. This article proposes the concept of promisekeeping as a remedy to the sometimes contradictory positions in which patients and providers find themselves. Composed of honesty, explicit disclosure, flexible decision making, and, most of all, beneficence, promisekeeping is one method to ensure that all parties in the managed care system can succeed.
ISSN:0748-8157
2475-2797
DOI:10.1097/01974520-199610000-00003