Physicians Reestablishing Clinical Autonomy. (Part 1: Value-Based Health Care)‪.‬

CONVENTIONAL WISDOM BELIEVES PHYSICIANS gratuitously rail against the managed care industry because of declining incomes. In fact, their frustrations are more directed at diminished clinical autonomy than decreasing salaries. Managed care has devalued physicians' decisions and their role as patients' advocates. If America's excellent health care delivery system is to survive, this pernicious trend must be reversed. And physicians must initiate the transformation. Physician leadership, coupled with the intelligent use of clinically reliable information, will enable independent provider groups to successfully manage financial and clinical risks. Such measures can also select and differentially reimburse participating physicians on the basis of continuously improving care processes and clinical outcomes, including patients' health status and satisfaction. Physicians will then be able to market themselves on value, determined by both quality and price.