PEDIATRICS Vol. 92 No. 4 October 1993, pp. A80
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COURTS LET UTILIZATION REVIEW FIRMS OFF THE HOOK—AND LEAVE DOCTORS ON

J. F. L. MD

One of the most striking—and disturbing—changes under way in medicine is the rapid erosion of the physician's authority for managing the patient. More and more allied health professionals and organizations such as HMOs and PPOs clamor for the right to direct patient care.

Yet when it comes to assuming some of the risk for malpractice suits, these groups want the burden to remain entirely on the doctor.

Another claimant to knowing better than doctors what patients need: the utilization review firm. UR companies have made doctors' lives miserable by denying hospitalization, demanding earlier discharge, and generally questioning every aspect of patient management.

When a malpractice suit arises, though, the UR firms all too often deny any responsibility. How? They say they're just interpreting the benefits a plan offers. This and other forms of legal hairsplitting leave the doctor holding the malpractice bag.