Prepaid Entitlements: A New Challenge for Physician-Patient Relationships

James L. Schroeder*, John T. Clarke, James R Webster Jr

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


The transition from a fee-for-service model to a prepaid health care system creates new challenges for both physicians and patients. Occasionally both can feel trapped in the new setting and must rely on new or different strategies to reach sometimes divergent objectives. This may alter the physician-patient relationship in ways that neither likes. Based on our experience in a large multispecialty academic group practice, we have developed management strategies to mitigate such stresses on both parties. These include review of marketing efforts; education of new patients to foster realistic expectations; a physician-generated, prospective internal policy for dealing with dissatisfied patients and physicians; a strong central administrative physician to serve as a “lightning rod ” and counselor; and continuing physician orientation and education to improve judgment and attitudes. These strategies promote the physician's role as expert consultant-educator with the best interests of the patient as the first priority.

Original languageEnglish (US)
Pages (from-to)3080-3082
Number of pages3
JournalJAMA: The Journal of the American Medical Association
Issue number21
StatePublished - Dec 6 1985

ASJC Scopus subject areas

  • Medicine(all)


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