Managed Care

In Reply.— Dr Robbins' criticism of our paper1 essentially makes two points. First, Dr Robbins criticizes the evaluation of physicians' perceptions of managed care systems because, he feels, these perceptions are largely self-serving. (We presume that Dr Robbins does not criticize the whole field of survey research.) Second, Dr Robbins is concerned that the reported perceptions are not validated by patient-level analysis. As mentioned repeatedly in the paper, the survey was designed to measure perceptions. Whether these perceptions are self-serving cannot be determined by the research tools that we used, or by any others that we know of.