Cost Containment: Challenging Fidelity and Justice

Cost containment heralds a general tightening of health care funds, subjects every health care intervention to scrutiny for its economic as as its medical wisdom and imposes upon physicians a variety of controls incentives. Fiduciary fidelity is challenged by the conflict between authority and patient loyalty, by financial and professional that pit the physician's own interests against those of his or her, by the stratification of resources which results in greater scarcity funds for indigent care, and by standardization of care through the of "efficiency protocols." Questions of clinical justice are in the areas of distribution of medical services and of contractual among patient, payer, physician, and institution. (KIE)