Presented at the Annual Meeting of the Central Section of the American Federation for Clinical Research, Chicago, IL September, 1991. Clinical Research, vol 39, Sept. 1991. 

"Clinical Freedoms within Proposed Medical Care Plans."

John H. Frenster, M.D.
Physicians' Educational Series
Atherton, CA 94027-5446 



Many new plans for medical care have been proposed with emphasis on cost containment, quality assurance and managed care, but with the question of freedom-of-choice for patients and physicians minimally analyzed. The present MediCare program and each of 14 new medical care plans were ranked by matrix cognition decision-making microcomputer programs (Clinical Research, vol. 39, 411A (April, 1991) for each of 10 criteria of clinical freedom (choice of physician, choice of practice, choice of hospital, choice of nurses, choice of work-up, choice of therapy, choice of referral, choice of payment, choice of follow-up, choice of survival). Choices of physician, of survival, and of therapy were the most favored clinical freedoms, with the present MediCare program ranking intermediate in providing clinical freedoms, the Canadian plan ranking the lowest in such freedoms, and the double-voucher plan for patients and physicians ranking highest. It is concluded that clinical freedoms are of diverse types, can be estimated clinically, and can affect the acceptance of new plans for medical care. 

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Physicians' Educational Series
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clinicalfreedom: "the ability of the patient and the physician to do all that is medically necessary without interference."