Eating Disorders - fieldi

110 Eating Disorders and Managed Care
managed care organizations about their employees’ medical and
psychiatric care. Whereas it is illegal to use health data in hiring and
firing people, it is not illegal to have such information and to use it
in undisclosed ways. Medical records, like financial profiles and buying
habits, have become a hot commodity to be cataloged and traded
like baseball cards. One of my recovered patients was refused life
insurance because the company had discovered that she had been
treated for bulimia. Many people would rather pay for their treatment
or forego treatment rather than have an eating disorder diagnosis
on their claim form. A number of practitioners have opted to
work outside the managed care system and negotiate fees with their
patients rather than share privileged information and be subjected to
the arbitrary control of managed care.
Kathryn Zerbe (1996) advocates forming an alliance with the
managed care case manager that involves sharing as many details as
possible about eating disorders, including critical information, so
that the treatment can be supported. On occasion, she sends articles
to the case manager documenting statistics and research trends.
Cost-offset data and outcome data can also be persuasive. Zerbe
describes a case in which the patient became her own advocate with
the case manager. She underscored that, “in the current age, clinicians
must work with the case management process until a better,
more direct way is found to adjudicate claims.” While the system of
payment for medical care goes through the present transition, practitioners
and patients are faced with having to accommodate to a system
which, in many ways, is seriously flawed. Often practitioners
now find it necessary to intervene and to become advocates on behalf
of their patients (Andersen 1998, 277). It is hoped that through the
efforts of citizens and the government a sound and equitable system
for the payment of medical care emerges in the new century.
References
Andersen, Arnold E. 1998. “Treatment of Eating Disorders in the Context
of Managed Care in the United States: A Clinician’s Perspective.” In
Walter Vandereycken and Pierre J. V. Beaumont, eds., Treating Eating
Disorders: Ethical, Legal and Personal Issues, 261–82. London: Athlone.