Richard Hall is a clinical psychiatrist for patients and their families and a forensic psychiatrist providing expert witness and medical services to the legal, government and private communities at the local, state, national and international levels since 1969. Dr. Hall maintains a private practice in psychiatry and forensic psychiatry in Lake Mary, Florida.He is also a Courtesy Clinical Professor of Psychiatry at the University of Florida, College of Medicine Gainesville, Florida. He received his undergraduate degree from the Johns Hopkins University and his Medical Degree from the University of Florida College of Medicine, Gainesville.
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This article addresses several ethical, regulatory and legal issues in managed care with attention to recent court cases that focus on physicians' responsibility, fiduciary duty and the impact that these legal decisions have on physicians practicing in a managed care environment. Discussion of the impact of changes in the control of decision making processes for physicians, the use of managed care protocols, restriction of resources and gatekeeping systems are addressed as are the specific duties and obligations of physicians to their patients.
During the last decade, managed care and "managed competition" have become a fate accompli in American medicine. In 1982, Paul Starr's book, "The Social Transformation of American Medicine" (33) received considerable national notoriety. Starr traced the evolution of American medicine over the last two centuries focusing on the changes in attitude toward physicians and the services that they provide.
These mental and addictive disorders cost our society 273.3 billion dollars in 1985. Of this, 43.7 billion dollars accrued from lost earnings due to premature death. Treatment related costs of mental illness totalled 65.6 billion, while the costs incurred by other social agencies, such as law enforcement, courts, fire departments, shelters etc., for the care of the mentally ill, represented an additional 65.6 billion.
Court cases in Arizona, California, and Florida have resulted in rulings that have assisted physicians in providing better care to their patients by maintaining the doctor-patient relationship, which is so often disrupted in managed care systems. The cases described here suggest that physicians should not be forced to make decisions against their patients' best interest, that physicians are responsible for their behavior, and that they need to stand up for their patients.
Reviews (1)
Anna D.
Jun 27, 2021
The WORST. Takes his Harvard John Hopkins White Privileged Male Attitude to entire new heights. He is deceitful and non-transparent. His Unsolicited Diagnosis are so Off The chart it is a wonder to how Hall stays in business, He is loyal only to his pocketbook, not medicine. He lines his pockets deep with wealthy employers using the title of "Forensic Psychiatrist." His persona and motive are questionable at best, and he misrepresents whatever you tell him. Hall asks questions which are irrelevant and concerning If your employer sends you to him, beware. He doesn't represent ANY kind of medicine, just his money.
