Does anyone think managed care actually improved the way in which a healthcare provider make medical decison?

Managed care. Managed care assumes physicians are wasteful with health care resources, and need a watchdog. It's become a 3rd party between patients and their doctors, deciding what appropriate care should be -- or at least limiting payment for it. I've been on the phone with such companies for hours, on behalf of my patients. It's never helped me make better decisions, but has sure absorbed my time.