Empirical research in contemporary academic contexts

¶ … managed care is used in modern medical practice as a variety of fiscal techniques used in a supposed dual role -- to reduce the cost of providing health benefits and to improve the quality of health care. The idea of managed care, now more typically known as the HMO, or Health Maintenance Organization, was a result of the 1973 Health Maintenance Organization Act, initially providing grants and loans to expand HMOs and improve care while reducing costs (Public Law 93-222). In the United States, managed care is really ubiquitous but has been part of the recent controversy of health care in the United States. Largely, the conundrum surrounds the fact that the overall goal of HMOs were to control costs while still providing increasingly higher quality of health care for the majority of the population. Many believe that neither goal has been met, which affects medical care in every branch; mental health, hospitals, clinics, dentists, pharmacies, and more (Health Care Costs, 2007).

Concerns about managed care and how it has impacted the practice of psychology are the topic of a study by Rupert and Baird entitled, Managed Care and the Independent Practice of Psychology (2004). Unfortunately, using their own data, plus data from two national surveys (1996 and 2001), managed care payments and regulations are a large source of stress that requires a number of unnecessary constraints, additional bureaucratic paperwork, and a tangible negative effect upon the individual psychologists, often taking their focus and time away from patient care simply in order to survive in the "system."

Researchers have known for some time that managed care tended to negatively impact the lives of medical personnel from all fields. From the basic issue of being part of a network; certification, billing, reimbursement, cost containment, permissions for procedures, etc., income is quite often decreased and patient care sometimes adversely impacted due to time constraints, the need to hire a dedicated insurance person for the office, and the innumerable and sometimes counter-productive, forms and questions the HMOs ask of their medical professionals (See: Zimet, 1989, 2002).

The survey instruments were both quantitative and qualitative in nature, and included four to six sections: basic demographics; general information about the practice (theoretical orientation, hours worked, staffing, etc.); basic locus of stress and attitudes towards practice; financial aspects of the practice; and a burnout inventory (designed to identify factors contributing to job or field burnout). Sample sets were then cross-tabulated and the results presented in tabular form, along with a robust discussion.