|
Physicians Withhold Information on Treatment
Choices
A July 8, 2003 Associated Press story that appeared
on the MSN and the InteliHealth websites reported on a study showing that
doctors withhold offering health care choices to their patients based on
the types of insurance coverage they have.
The study
shows that nearly one in three doctors reports withholding
information from patients about useful medical services that aren’t
covered by their health insurance companies. The
authors of the study say their work offers the first solid evidence that
coverage limitations imposed by managed care is having a profound effect
on doctor-patient recommendations.
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 says, "Patients aren't getting
the whole story". 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.” The results of the survey, which
was conducted in 1998 and 1999, were analyzed in the July 9, 2003 edition
of the medical journal "Health Affairs." The results showed 42 percent
said never, and 27 percent said rarely. But surprisingly, 23 percent said
“sometimes,” and 8 percent said “often” or “very often.”
The articles noted that while ethics codes require
doctors to disclose "medically appropriate treatment alternatives,
regardless of cost, a lot of doctors are nervous about describing
medically indicated ... care that isn't covered" by insurance. William S.
Custer, a professor in the Insurance Department at Georgia State
University, said doctors have always factored a patient's ability to
afford treatment into their medical advice. He notes, "Doctors have done
that since the days of Marcus Welby. They understood what the patient
could afford and offered services that would fit what they could afford."
Several years ago, some managed care companies
barred doctors from discussing medical options not covered by the health
plan. Those rules, known as “gag clauses,” were abandoned by most
companies because of public outcry. Additionally, many states passed laws
banning gag clauses from insurance policies and contracts.
|