An Editor’s Problem: How To Stay Humble

Overconfidence is rarely the danger in monthly magazine publishing, but I keep D.H.’s letter taped to my wall to guard against it, just in case. D.H. is the Washington State physician who took the trouble to write us, “I find your publication singularly worthless and do not wish to ever receive it again.” The note was dated April 1, and we naturally hoped the infinitive-splitting Dr. H. was only fooling, but the months since have failed to bring a follow-up note gloating, “Gotcha!”

Such is the human propensity for denial that we convinced ourselves that only one thing about our magazine could make D.H. that mad: our title. Some physicians simply cannot abide managed care, and don’t want to see anything in the mailbox that bears its name. But it so happens that a recent independent readership survey gave Managed Care better notices than D.H. did. In fact, it gave us a pretty good claim to being the best-read magazine devoted to — you guessed it — managed care.

A year ago we launched a special edition with the cover article targeted to managed care organization executives. The recent survey results, we’re happy to conclude, seem to bear out the wisdom of that initiative. But it didn’t come without a price.

The mere fact that Managed Care serves HMO and preferred-provider organization administrators as well as contracting physicians disqualifies us from one particular approach to medical-business journalism. That approach cozies up to physician readers and presumes to anticipate their every harrumph: “Look what those so-and-sos are doing to you now!”

Frankly, we’ve never cared for that patronizing style anyway. We cherish our freedom to point to the warts in managed care — witness our discussion of gag rules a year before they became hot — and we’ll continue to do so. But managed care is here to stay. So we also want to address affirmatively how doctors can thrive in the business of medicine, and we’ll keep doing that, too. Even if it means we’ll never be D.H.’s favorite read.