Sunday, June 14, 2009

AMA Promotes Physician Profiling of Consumers

Several posts ago, I mentioned that the actions of care providers in the US appeared to be taking away the rights of consumers of medical care ~ in that post particularly, birthing women.

During the week of June 14 - 20th, delegates at the Annual Meeting of the AMA will be voting on a Michigan resolution (Resolution 710) which proposes to develop CPT (billing) codes to identify and label “non-compliant” patients. Blaming some of the hostility on the economy and increasing co-pays, the authors of the resolution state that "the stress of dealing with ungrateful patients is adding to the stress of physicians leading to decreased physician satisfaction".

The resolution goes on to say that "increasing noncompliance with treatment can reflect negatively on physicians during black box audits by insurance companies and oversight governmental agencies".

Absent from Resolution 710 is any caveat for patient/client autonomy or any suggestion that the physician is the service provider and the patient/client is the consumer. This may have very serious implications for maternity care consumers as pregnancy is a condition of normalcy and health, not one of illness or crisis.

The following was excerpted from the International Cesarean Awareness Network's response to this Resolution:

A recent report by Childbirth Connection and The Milbank Memorial Fund, called “Evidence-Based Maternity Care: What It Is and What It Can Achieve,” shows that the state of maternity care in the U.S. is worrisome, driven largely by a failure of care providers to heed evidence-based care practices. For most women in the U.S., care practices that have been proven to make childbirth easier and safer are underused, and interventions that may increase risks to mothers and babies are routinely overused. The authors of the report point to the “perinatal paradox” of doing more, but accomplishing less.

The resolution proposed by the Michigan delegation of the AMA could threaten patient care and patient autonomy for several reasons:

• Billing codes that would categorize any disagreement and exercise of autonomy on the part of the patient as “non-compliance” “abuse” or “hostility” could create a pathway for insurance companies to deny coverage to patients

• Use of these labels fails to recognize patients as competent partners with physicians in their own care

• Tagging patients as “non-compliant” fails to recognize that there is not a “one size fits all” approach to care, that different opinions among physicians abound, and that patients are entitled to these very same differences of opinion

• Labeling patients as “non-compliant” may, in fact, be punitive, jeopardizing a patient’s ability to seek out other care providers.

If you believe in a Patient's Bill of Rights, please blog or use any social media to inform expectant parents about this tipping of the balance of ....power.

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