Abstract
What is the essence of clinical caring, how can its value be determined, and what are its origins? Caring for a patient is a bit like loving someone. In both cases, the wellbeing of the person who is loved or the patient who is cared for is felt to be overridingly important. Good clinical care goes beyond the diagnostic services, prescriptions or operations that the patient is billed for. It includes services done free of charge for the satisfaction of easing the patients’ distress or enhancing their sense of security or optimism while they cope with illness. Love and clinical caring are not commodities to which market values have relevance. They have value without price. Whereas a person in the business of selling services is motivated by the prospect of making a profit, the altruistic clinician is motivated by the desire to help the patient. He or she is paid to be sustained, albeit comfortably, not to be made rich (Thomas, 1983, pp. 1–18).
I am a practicing pediatrician who attended the conference on “The Ethics of Managed Care” in May, 2001, in Kansas City, Missouri. I was prompted to write this critical review by my sense that not enough attention was given to the psychological and emotional factors relevant to healthcare delivery. This essay has four parts: 1) an examination of caring; 2) a critique of some key tenets of managed care; 3) the limitations of the free market solution to problems of healthcare delivery; and 4) the similarities and differences between medicine and other learned, service-providing professions.
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Fleisher, D.R. (2002). Care and Managed Care: Pyschological Factors Relevant to Healthcare and Its Delivery. In: Bondeson, W.B., Jones, J.W. (eds) The Ethics of Managed Care: Professional Integrity and Patient Rights. Philosophy and Medicine, vol 76. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-0413-7_11
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DOI: https://doi.org/10.1007/978-94-017-0413-7_11
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