Abstract
There have been numerous negative reactions to managed care from health care providers, as well as from employers and patients. Some feel that the care that doctors provide to their patients may be compromised by a need for managerial profits for managed care programs. Four ethical situations that doctors face under managed care systems are described. A survey of general practitioners and surgeons show how doctors would respond to certain dilemmas and the extent to which exposure to such situations influence them to leave a managed care plan.