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FreeRepublic , LLC PO BOX 9771 FRESNO, CA 93794
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Posted on 07/08/2003 1:12:23 PM PDT by freepatriot32
WASHINGTON (AP) - Nearly one in three doctors reports withholding information from patients about useful medical services that aren't covered by their health insurance companies, and the number may be on the rise, a study reports.
Study authors say their work offers the first empirical evidence for what many have long suspected: that coverage limitations imposed by managed care are infiltrating doctor-patient communications.
``Patients aren't getting the whole story,'' said Matthew K. Wynia, director of the Institute for Ethics at the American Medical Association and lead author of the article being published in the journal Health Affairs.
Wynia and his colleagues surveyed 700 physicians and asked how often they had decided not to offer a ``useful service to a patient because of health plan rules.'' Forty-two percent said never, and 27 percent said rarely.
But 23 percent said ``sometimes,'' and 8 percent said ``often'' or ``very often.''
The results harken back to several years ago, when some managed care companies barred doctors from discussing medical options not covered by the health plan. Public outcry persuaded most companies to drop those rules, known as ``gag clauses,'' and many states banned them from contracts.
The study found that doctors whose own salaries are closely tied to controlling costs were more likely than other doctors to report withholding information.
In addition, those who serve a large number of Medicaid patients were more likely to stay silent, as were those who believed patients might want them to deceive their insurance companies to get services covered.
Authors note an important caveat: The term ``useful service'' was not defined in the survey. To one doctor that could mean steering a patient to a generic drug rather than the more expensive brand-name version, while to another it could mean not mentioning a major surgical procedure.
The most positive interpretation of the study's results would be that doctors are withholding information on services that might be useful but are less clearly necessary than others, said Dr. Hoangmai Pham, senior health researcher at the Center for Studying Health System Change, who was not part of the research team.
The most negative interpretation, she said, is that doctors have been conditioned to withhold information, shortchanging patients.
All of it can be compounded by time pressures, Pham said: Doctors with a limited amount of time with a patient may not spend it talking about services that the patient has no way to pay for.
``It's simply not possible to discuss everything with every patient,'' she said. ``You might go down your list of three or five top options but not discuss every last one.''
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FreeRepublic , LLC PO BOX 9771 FRESNO, CA 93794
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It is in the breaking news sidebar! |
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While I think it's reprehensible if a physician would purposely withhold vital information from a patient, I find it troubling that so many would not do the necessary homework to ensure their own best interests.
This is quite important. I want a more detailed survey or study which clarifies the significance of this finding before I decide what exactly I think on this.
On the other hand, when there is little or no progress in the way of diagnosis or cure for a respiratory ailment after multiple visits to the doctor and numerous prescriptions, ...maybe it's time to change doctors and start all over.
I AM KEEPING THINGS FROM YOU!!!!
LOL. Truly destined to become a classic line. Kudos, doc.
To accomplish that, we need to make the lergal changes it will take to allow patients to make their own medical decisions! Shifting the insurance tax deduction from corporate to individual returns is a biggie. Currently, patients are denied the opportunity to choose insurance plans other than those offered by their employers; if you're self-employed, you're screwed, because insurance companies will only deal with groups.
The other major reform we need is to give patients an unconditional right to shop for medications on the world market, by buying across borders or on the Internet. Earlier this week on my visit to Minnesota, I attended a conference session hosted by Peter Wyckoff of the Minnesota Senior Federation. The MSF is lobbying to get cheaper prscriptions for its senior membership in a number of different ways. Mostly, this consists of the sorts of socialist nostrums you would expect: state-issued subsidy cards, and the like. But the cornerstone of MSF's plan turned out to be something I never expected in the "Land of 10,000 Treatment Centers": sneaking across the border and buying drugs in wide-open border towns like Toronto.
MSF 'gets it' about the power of the free market, and understands that since Big Pharma sells the same products for radically different prices in different countries, the best way to lower US prescripton prices would be to allow American seniors to deal, singly or in groups, in the world markets.
Ever told them about alternatives rather than drugs or examinations?
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