The descriptions and impressions of managed care are like the pronouncements of the blind men of Hindustan who encountered an elephant. One felt the trunk and said it was like a snake, another felt the tail and said it was like a rope, another grabbed the ear and said it was like a leaf, and on and on. Thus, the payer, the provider, the patient, the teacher, the student, the primary care physician, and the specialist all see managed care in different ways—some reassuring, some threatening, some good, some bad, but all new and different. This month the Journal of the American Medical Association and the associated family of Archives are featuring managed care as our theme.
Neurologists make up a small number of physicians, but, with the aging of the population, we are taking care of more and more patients. Patients who often have chronic and disabling illnesses. These