ds be left to the physician while dollars and cents can remain with the financial officer. Managed care theoretically may seem appealing, but most view managed care practices as emphasizing cost control over quality.The ethical arguments of managed care are dependent on the goals of the physician and the provider. If the primary goal is always doing the best for the patient within the limits of available resources and less interest for the bottom line then subjecting patients to unnecessary risks is minimal. However, if the patient is regarded as a secondary issue the physician and providers are ethically wrong. “It is the position of the National Academies of Practice that is unethical to compromise a patient’s needs and quality care concerns to satisfy financial objectives” (Pope, K. S. & Vasquez, M. J. T., (1998) pg. 322). The APA Ethical Principals of Psychologists and Code of Conduct (Section 4.09c) states, “Prior to termination for whatever reason, except where precluded by the patient’s or client’s conduct, the psychologist discusses the patient’s or client’s views and needs, provides appropriate predetermination counseling, suggest alternative service providers as appropriate and takes other reasonable steps to facilitate transfer of responsibility to another provider if the patient or client need ones immediately” (American Psychological Association, 1992, pp. 1597-1611). As a result of managed care policy limitations, referrals may become necessary. Managed care assumes the ability to predict how long it will take to heal mental health issues, and may not include or recognize certain diagnosis. Managed care places a therapist in a precarious position. Therapists will now need to make the “appropriate” diagnosis to cover therapy while acting also for the managed care organization. This practice called double agentry is one of the challenges facing managed c...
