System Constraints on Optimal Care

Health care systems operate at many levels and take many forms: hospital risk management policies, insurance company coverage determinations, Medicaid and Medicare reimbursement rules, the medical malpractice system, federal regulation of physician business practices, and national health association policies. This month's issue looks at how these systems—essential to the delivery of health care in the 21st century—affect the day-to-day practice of medicine and how physicians manage the unintended consequences of systems that sometimes constrain good patient care.
Volume 10, Number 5: 263-354 Full Issue PDF