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Clinical communication and managed care.

Both physicians and patients are feeling the force of managed care as they interact. Questions concerning the impact of financial relationships on care delivery are more public than ever and can form a disturbing subtext in the examination room. The poor communication that results can be bad for patient care in and of itself. Training, measurement and consideration of clinical communication can help bring such issues to the fore, improve the alliance between physician and patient and help both deal with the vagaries of modern medicine.