MANAGED CARE AND YOU: The Consumer Guide to Managing your Health Care by Michael E. Cafferky, Mc Graw Hill, Inc., New York, 210 pages, 1995

Review by Del Meyer, MD

At first glance this looks like another self_help book, chock full of helpful doís and doníts about how to select a managed care organization (MCO), and Iím certain that this is what the author set out to write. But it soon becomes apparent that his personal agenda, the promotion of managed care as the health care paradigm of the future has had a major influence on his presentation.

Michael Cafferky is an integrated health systems administrator for a hospital in Washington state who travels the country doing management consulting and giving seminars. A closer look at his credentials reveals degrees in public health and marketing. Ah! This explains the tendency toward persuasive language and glib statistics (from uncited sources) in round numbers which seem to point to the inevitability of the move to managed care.

The book, an exhaustive analysis of the managed care marketplace and how it ought to work, consists of 20 chapters, 2 or 3 of which are obviously targeted toward the health care consumer. The remainder would make a passable textbook for a business school course in managed care, and if I were the Director of Human Resources for a large HMO, I would probably make it required reading for the management training of newly hired administrators.

The information in this book could certainly be of use to anyone who utilizes managed care. However, if it is true, as the author states, that subscribers donít understand how MCOís work because they donít read the enrollment packet that they receive from their employer, then it is even less likely that they would read all the way through this minutely detailed handbook for making the most of their managed care coverage. Only the most obsessive compulsive of health care consumers would actually adopt this as a guide to maximizing their satisfaction with their MCO.

Before you cross this off your summer reading list, however, consider passing it along to your office staff. The same strategies that make one MCO better than another, apply to any type of medical practice. A good broad grasp of managed care logic will enable your staff to make better choices and give better advice or information when dealing with your patients.

This book may also provide valuable insights to physicians. Since it is ostensibly written to the consumer, it deals with things which are of vital interest to patients, and even goes so far as to tell the reader what ought to be of serious concern and why.

One caveat however: remind anyone who reads this book to consider the source when evaluating any conclusions which the author leads them to. Cafferky is a very effective, highly paid, well trained and extremely successful salesman. His product is managed care. This book represents but one side of a multifaceted issue, and in the hands of a competent author, the other sides would make equally efficacious reading. Accepting this book as the definitive guide to managed care is like taking Bill Gates word for the fact that Windows 95 is, without a doubt, the best computer operating system to come along in the past 30 years.