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Nonabandonment: Medical Ethics
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
Quill and Cassel's concept of nonabandonment [1] is a worthwhile ethical obligation inherent in the physician–patient relationship. However, this concept is largely irrelevant in today's economic climate.
The relationship may be ripped asunder if the patient's employer chooses to change insurance companies. If the physician is not part of the panel, the patient may not be permitted to see the physician at all. Within the network, if the relationship is between a patient and a specialist, the “gatekeeper” must agree to maintain the relationship. Note that the gatekeeper might not have any choice either. Insurance plans actively monitor the number of referrals to specialists and penalize too many referrals. Continuity of care is not a recognized reason for referral.
Insurance companies routinely report that they feel an ethical obligation to the physician–patient relationship. But money talks louder.
Gregory B. Patrick, MD
Sewickley Medical Association; Sewickley, PA 15143
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
