The present study explored the effects of the current round of health care reforms on practicing physicians in terms of income, cost of care, and improvements in the quality of care. Six neurologists from various parts of the country, all facing widely differing environmental factors, were interviewed. The results demonstrate that health care reform has forced physicians to work more hours to maintain their incomes, has done little to control costs, and has generated little interest in quality improvement plans. In fact, due to referral patterns, quality levels may have decreased under capitated payment plans. The conclusion is that health care must be reformed at the local level and involve physicians with a wide array of specialties.
