Blog | Thursday, September 6, 2012

Get legislatures out of the office and away from the bedside


As the Chair of ACP's Health and Public Policy Committee I am absolutely thrilled to share our new position paper, "Internal Medicine Physicians Recommend Principles on Role of Governments and Legislation in Regulating Patient-Physician Relationship."

"The physician's first and primary duty is to put the patient first," David L. Bronson, MD, FACP, president of ACP, said. "To accomplish this duty, physicians and the medical profession have been granted by government a privileged position in society."

Dr. Bronson noted, though, that "some recent laws and proposed legislation appear to inappropriately infringe on clinical medical practice and patient-physician relationships, crossing traditional boundaries and intruding into the realm of medical professionalism."

Pointing to examples in ACP's paper, he expressed concern about laws that interfere, or have the potential to interfere, with appropriate clinical practice by:
--prohibiting physicians from discussing with or asking their patients about risk factors that may affect their health or the health of their families, as recommended by evidence-based guidelines of care;
--requiring physicians to discuss specific practices that in the physician's best clinical judgment are not individualized to the patient;
--requiring physicians to provide diagnostic tests or medical interventions that are not supported by evidence or clinical relevance; or
--limiting information that physicians can disclose to patients.

The paper, produced by ACP's Health and Public Policy with input from ACP's Ethics, Professionalism and Human Rights Committee, offers a framework for evaluating laws and regulations affecting the patient-physician relationship, rather than taking a position on the specific issues that are cited by lawmakers to impose particular restrictions or mandates.

This problem occurs from "well-meaning" legislators from both ends of the political spectrum. We do not believe that legislatures should influence how we practice medicine. The first paragraph of our paper captures our beliefs perfectly:

"The physician's first and primary duty is to put the patient first. To accomplish this duty, physicians and the medical profession have been granted a privileged position in society conferred by society and government."

Often in this blog and on the ACP advocacy blog we (ACP) are criticized for not advocating for physicians. We hope that virtually all physicians and patients will agree with these principles.

db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Associate Dean for the Huntsville Regional Medical Campus of UASOM. He also serves as a frequent ward attending at the Birmingham VA Hospital. This post originally appeared at his blog, db's Medical Rants.