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BOSTON-A group of Harvard Medical School-affiliated doctors is writing a strong prescription for managed care: HMOs and for-profit health care companies need to interfere less in the relationships between patients and their doctors.
"We don't want the doctor/patient relationship to become totally corporate," said Dr. Susan Bennett, one of the founders of the Ad Hoc Committee to Defend Health Care and a primary care internist at Brigham & Women's Hospital in Boston.
The 22 doctors of the committee, most of whom are affiliated with Harvard, want to rally their colleagues and sound them out before making clear recommendations about changes in health care plans. "We've been very careful not to pose a solution just yet," said Dr. Bennett. "There has to be a solution between a Canada-like system and one that is market-dictated," Dr. Bennett said. In Canada, virtually everyone has access to government-funded health care, but Canadians may choose their own doctors.
The committee announced May 28 that the New England Journal of Medicine this fall will publish the committee's statement, titled "Call to Action" and signed by more than 2,000 Massachusetts doctors. "Mounting shadows darken our calling and threaten to transform healing from a covenant into a business contract," the call states. It does not, however, make any specific recommendations for changes in health care plans.
"Ultimately, we want to open a national dialogue about health care," Dr. Bennett said.
A local group representing insurance buyers reacted negatively to the committee's point of view.
"Fundamentally, we don't agree with this group," said Paula Breslin, executive director for The Massachusetts Healthcare Purchaser Group in Burlington, Mass. The purchasing group has 70 members, including Amherst College and Hewlett-Packard Co.
"Health plans represent an accountable entity that doesn't exist in an indemnity situation," she said. Managed care adds value to health care, she said.
"This is not an anti-managed care movement," Dr. Bennett said. Doctors' roles, she said, have changed due to managed care, which has created "the transformation of a profession into skilled labor."