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Previous Volume 331:1151-1153 October 27, 1994 Number 17 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Despite complaints that the care provided by specialists is discontinuous and fragmented, Americans have traditionally valued their unrestrained access to care by cardiologists, dermatologists, urologists, and other specialists. But now the rapid spread of managed care is dramatically changing how referrals to specialists are made. For example, most health maintenance organizations (HMOs) sharply limit access to specialists by interposing a "gatekeeper" physician between the patient and the specialist, and in the process many patients have lost an element of control over the kind of care they receive.

The cost of specialty care is a principal concern. Specialists are more expensive . . . [Full Text of this Article]

References

Related Letters:

Physicians and Managed Care
Weintraub M. I., Helsel E. V., Marino J. T., Iglehart J. K.
Extract | Full Text  
N Engl J Med 1995; 332:1173-1174, Apr 27, 1995. Correspondence

Access to Specialty Care
Diamond C., Weinberger M., McAfee R. E., Silverblatt J. H., Zink T. K., Kassirer J. P.
Extract | Full Text  
N Engl J Med 1995; 332:474-476, Feb 16, 1995. Correspondence

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