What Is Left of Professionalism after Managed Care?
by William M. Sullivan The “managed care revolution” has meant that financial imperatives, whether in the form of cost cutting or profit seeking, threaten to pre-empt professional judgment in the way medical treatment and care are administered. In their scope and speed these changes are unprecedented, and they challenge not only the interests but the identity of the medical profession. As recently as three decades ago, medicine was often described as the “model profession,” able to shape its own conditions of practice and secure in its future. Today, medicine is under siege. The question is whether and how it might preserve its professional identity and whether it will still play an important role in determining how to meet the collective health needs of American society. A renewed and significantly reformed professionalism could prove a most valuable resource in the face of these challenges, not only for health care but for the nation as a whole. It will have to be a significantly ref
