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Barriers to Health Care, Prescription Choice Hurt Patients, Leading Doctor Says
Date:4/28/2009

WASHINGTON, April 28 /PRNewswire/ -- A major barrier to health care is unauthorized prescription drug switching, said Dr. Richard Allen Williams, a leading author and founder of the Minority Health Institute.

In his keynote address to the National Minority Quality Forum in Washington Monday, Williams said the U.S. would be better served if physicians had more say to make decisions based on patient's needs without artificial barriers set by outside parties.

The National Minority Quality Forum, a leader in tackling the issue of health disparities, hosted its Sixth Annual Health Disparities Leadership Summit April 27-28 at the Ritz Carlton Hotel in Washington.

Gary A. Puckrein, PhD, President and CEO of the National Minority Quality Forum (formerly the National Minority Health Month Foundation), founded the organization in 1998 to address the critical need for strengthening national and local efforts to use evidence-based, data-driven initiatives to guide programs to eliminate the disproportionate burden of premature death and preventable illness for racial and ethnic minorities.

Speaking at the event, Williams noted that a survey by the Medical Society of the State of New York shows that more than 90 percent of physicians indicated they had to change patient treatment (or medication) based on restrictions from insurance companies.

Williams said restrictions should be eased so doctors, for example, have more flexibility in ordering diagnostic tests instead of requiring prior authorization; develop formularies based on appropriate clinical evidence; and protection of patients from formulary changes.

Doctors are finding it more difficult to care for patients because of restrictions placed on their decision-making ability. For example, every day physicians have their authority and expertise questioned by insurance companies through "switching" - when an insurance company pressures doctors and patients to switch from a medicine that may be working well to either a less-expensive generic alternative or another cheaper drug that might have different active ingredients. The result for some patients is increased risks and less effective care.

Much of the time, physicians prescribe the least expensive medication or generic equivalent for the best medical outcome. They don't need third parties questioning the drugs they prescribe and the reasons for those prescriptions.

Williams wrote "The Textbook of Black-Related Diseases," which details medical conditions peculiar to African Americans. It's the only book of its kind and is considered the classic seminal work on the medical status of blacks.

Also speaking on the National Minority Quality Forum panel was Tammy Banks of the American Medical Association. Banks, Director of the Practice Management Center and Payment Advocacy, spoke on the "Diagnosis and Cure for the Broken Claims Process."

To help reduce the substantial administrative burden of ensuring accurate insurance payments for physician services, Banks said the AMA launched the Heal the Claims Process campaign to help cure the ailing system of processing medical claims with health insurers and unveiled the first AMA National Health Insurer Report Card on claims processing.

A third panelist, David Satin, MD, spoke on "The impact of Pay For Performance On Health Care Disparities." He discussed the pros and cons of pay for performance and how it might impact health disparities.

Satin is a Postdoctoral Fellow at the University of Minnesota's Center for Bioethics and Assistant Professor in the University's Department of Family Medicine and Community Health. He practices family medicine at Smiley's Family Medicine Residency Program in Minneapolis.


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SOURCE National Minority Quality Forum
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