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Previous Volume 330:639-641 March 3, 1994 Number 9 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.

	Full Text Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article by Emanuel, E. J.

To the Editor: Emanuel and Brett (Sept. 16 issue)¹ describe a number of mechanisms by which managed competition may disrupt patient-physician relationships. Prominent among these is involuntary disruption of continuity of care as patients are forced to change health plans.

This process compromises care in a more insidious fashion as well: it gives providers a disincentive to invest in preventive care. I recently had the opportunity to discuss with an executive of a health maintenance organization (HMO) the importance of the participation of diabetes educators in the care of patients with diabetes, a service that this HMO did not provide . . . [Full Text of this Article]

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