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Pulmonary Practice Profiles : Results of a Practice Performance Survey

Stanley Goldfarb, MD; Christopher Higgins, CPA
Author and Funding Information

Affiliations: Philadelphia, PA
 ,  Richmond, VA
 ,  Dr. Goldfarb is Professor of Medicine, University of Pennsylvania School of Medicine. Mr. Higgins is Executive Director, Department of Internal Medicine, Virginia Commonwealth University.

Correspondence to: Stanley Goldfarb, MD, University of Pennsylvania, 3450 Hamilton Walk, Philadelphia, PA 19104-6087; e-mail: stanley.goldfarb@uphs.upenn.edu.



Chest. 2006;130(3):636-637. doi:10.1378/chest.130.3.636
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John Kenneth Galbraith

Economic research suggests that relatively minor components of a physician’s capitation income could influence physician behavior.1 Moreover, when faced with the dual tasks of caring for patients’ physical well-being and bearing the financial risk of their care under managed care contracts, physician-owned groups seem to gravitate toward the same devices used by insurance companies to save costs. These devices include the use of a primary care physician as a gatekeeper, preauthorization programs in which nurses or physicians judge the appropriateness of referrals for specialty care or complex and expensive diagnostic procedures, and, to a lesser extent, the creation of guidelines or other educational tools to help clinicians provide care.2

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