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Gatekeeping Revisited — Protecting Patients from Overtreatment
Abstract
Over 90 percent of health maintenance organizations (HMOs) use primary care physicians as gatekeepers,1 whose role is to authorize access to specialty, emergency, and hospital care and to diagnostic tests. Gatekeeping has come to imply the medically limited and bureaucratic function of opening or closing the gate to high-cost medical services. This simplistic view of gatekeeping is controversial,2 , 4 both because of its menial connotation and because of the implication that the physician is the agent of the third-party payer, not the patient. The purpose of this paper is to reclaim the gatekeeper concept and to emphasize a more empowering role . . .
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Cited by
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Wagner, E. H., Austin, B. T., & Korff, M. V. (1996) · The Milbank Quarterly · doi:10.2307/3350391 · Cited by 2,877
Data resource profile: Clinical Practice Research Datalink (CPRD) Aurum
Wolf, A., Dedman, D., Campbell, J., Booth, H., Lunn, D., Chapman, J., & Myles, P. (2019) · International Journal of Epidemiology · doi:10.1093/ije/dyz034 · Cited by 861
Defining and Measuring the Patient-Centered Medical Home
Stange, K. C., Nutting, P. A., Miller, W. L., Jaén, C. R., Crabtree, B. F., Flocke, S. A., & Gill, J. M. (2010) · Journal of General Internal Medicine · doi:10.1007/s11606-010-1291-3 · Cited by 516
Self-citationThe Empirical Foundations of Telemedicine Interventions in Primary Care
Bashshur, R. L., Howell, J. D., Krupinski, E. A., Harms, K. M., Bashshur, N., & Doarn, C. R. (2016) · Telemedicine and e-Health · doi:10.1089/tmj.2016.0045 · Cited by 370
Metadata
- Authors
- Franks, P., Clancy, C. M., & Nutting, P. A.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1992-08-06
- Volume
- 327
- Issue
- 6
- Pages
- 424-429
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W1965417958
- Cited by
- 327
- References
- 0
- FWCI
- 68.02
- Type
- journal article
- Language
- en
- Open access
- closed
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- Franks, P., Clancy, C. M., & Nutting, P. A. (1992). Gatekeeping Revisited — Protecting Patients from Overtreatment. New England Journal of Medicine. https://doi.org/10.1056/nejm199208063270613
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
