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Risk Management Focus
Professional Ethics
Overview
Managed care, with its constraints on traditional medical practice, presents new challenges to physicians who want to provide quality care while satisfying insurers’ requirements for payment for medical services. If managed care organizations deny payment for services that physicians believe are necessary for patient care, physicians may find themselves in a dilemma. Should they provide the services despite the payment denial, and put the patient or themselves at financial risk for payment? Or should they acquiesce to the insurers’ determination of benefits, and possibly put their patients at risk for continued or exacerbated health problems?
Objectives
Upon completion of this course, a physician should be able to:
1. Understand the ethical dilemmas created by managed care organizations’ constraints on medical practice.
2. Be able to discuss two types of risk associated with practice in a managed care environment.
3. Be able to analyze a case study to identify the ethical and risk management implications of practice in a managed care environment
Target Audience
This course is designed for physicians who want to protect patient safety in a managed care environment.
Methodology
This is a self-study course consisting of text and CME test. Physicians should read the course content, answer the test questions and submit the answers for scoring. Those who complete the course with a score of 80 percent or higher will earn a maximum of 1 AMA PRA Category 1 creditTM.
Faculty/Author
This course was developed by Rosemary Gafner, Ed.D. Dr. Gafner’s CV is available on request or online at https://www.medrisk.com/Medrisk/Faculty/CV/default.aspx.
CME Information
Medical Risk Management, Inc. is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education for physicians. Medical Risk Management, Inc.designates this continuing medical education activity for a maximum of 1 AMA PRA Category 1 creditTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
This activity is valid for release May 1, 2007 and expires on April 30, 2010.
Commercial Support
This activity was developed solely by Medical Risk Management, Inc. without any outside commercial support.
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