Case vignette

the vicissitudes of managed care.

Carol Shaw Austad, Nicholas A. Cummings, Ruth Macklin, Russ Newman

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Lee Wilson, age 26, was referred to Dr. Jackson for psychotherapy 5 weeks ago by a friend. Lee has been feeling increasingly depressed about longstanding family issues and the recent breakup of a 2-year relationship with a live-in companion. Over the course of the once-per-week sessions, Dr. Jackson notes persistent suicidal ideation, with vague plans to act if, as Lee puts it, "things get any worse." Just before the sixth session, Dr. Jackson is contacted by a reviewer for the managed care health insurance program covering Lee's therapy. The reviewer informs Dr. Jackson that the company will not authorize payment for further psychotherapeutic care. Dr. Jackson knows that Lee is in need of continued treatment and fears that terminating therapy at this time could result in increased suicide risk. Lee's income could cover only a small portion of Dr. Jackson's usual fee. Dr. Jackson does not wish to abandon Lee, but he already provides a significant amount of reduced-fee service to other clients. Is the health insurance carrier's stance ethical? Should Dr. Jackson be expected to treat Lee for the foreseeable future at a greatly reduced fee? How should Dr. Jackson handle this situation?

Original languageEnglish (US)
Pages (from-to)215-226
Number of pages12
JournalEthics & behavior
Volume2
Issue number3
StatePublished - 1992
Externally publishedYes

Fingerprint

Managed Care Programs
Fees and Charges
Health Insurance
Fee-for-Service Plans
Insurance Carriers
Suicidal Ideation
Psychotherapy
Suicide
Fear
Emotions
Therapeutics

ASJC Scopus subject areas

  • Psychology(all)

Cite this

Austad, C. S., Cummings, N. A., Macklin, R., & Newman, R. (1992). Case vignette: the vicissitudes of managed care. Ethics & behavior, 2(3), 215-226.

Case vignette : the vicissitudes of managed care. / Austad, Carol Shaw; Cummings, Nicholas A.; Macklin, Ruth; Newman, Russ.

In: Ethics & behavior, Vol. 2, No. 3, 1992, p. 215-226.

Research output: Contribution to journalArticle

Austad, CS, Cummings, NA, Macklin, R & Newman, R 1992, 'Case vignette: the vicissitudes of managed care.', Ethics & behavior, vol. 2, no. 3, pp. 215-226.
Austad CS, Cummings NA, Macklin R, Newman R. Case vignette: the vicissitudes of managed care. Ethics & behavior. 1992;2(3):215-226.
Austad, Carol Shaw ; Cummings, Nicholas A. ; Macklin, Ruth ; Newman, Russ. / Case vignette : the vicissitudes of managed care. In: Ethics & behavior. 1992 ; Vol. 2, No. 3. pp. 215-226.
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