Navigation Links
For Patients' Sake, Insurance Companies Urgently Need a Code of Conduct

ENCINO, Calif., April 28 /PRNewswire/ -- Managed care companies are the only sector of the health care industry lacking a code of conduct. It is time for that to change.


Recently, the American Medical Association (AMA) drafted language for a National Health Insurer Code of Conduct. The code's four key principles are: clinical autonomy, transparency, corporate integrity and patient safety and welfare. I commend the AMA for drafting this code. Unfortunately, the health insurance industry has been silent on it.

Why is this code of conduct so important? Financial incentives -- not patient welfare -- are the driving force behind insurance operations.

A survey by the Medical Society of the State of New York showed that more than 90 percent of physicians indicated they had to change a patient's treatment -- or medication -- based on restrictions from insurance companies. A survey by The Toledo Blade of members of the Ohio State Medical Association and the AMA revealed that 95 percent of respondents said insurers interfered with decisions about prescriptions, 91 percent with testing, 74 percent with referrals and 69 percent with hospitalization decisions.

Every day insurance companies challenge physicians' authority and expertise. Studies and my personal experience reinforce that. This problem is particularly acute as insurance companies and pharmacy benefit managers seek to dictate a particular medication to prescribe. Insurance formularies and other barriers to specific medications make it difficult for doctors to prescribe the medication they deem the most appropriate.

In the worst cases, unauthorized drug switching occurs. That's when a medication is switched to another drug that is supposed to be its equivalent but might have different active ingredients -- often by a pharmacist and without the doctor's knowledge. This seemingly harmless switch can be detrimental to the patient, sometimes increasing risks and decreasing care.

We doctors prescribe the medication that's best per individual patient. Although in some instances a generic alternative might work, it is not always appropriate. The patient's doctor should make that determination, not an insurance company concerned with its bottom line.

The time has come for the health insurance industry to adopt a National Health Insurer Code of Conduct. The health and welfare of every patient is at stake.

Dr. Richard Allen Williams

Founder, President and CEO, the Minority Health Institute

Founder, Association of Black Cardiologists

Author, "The Textbook of Black-related Diseases"

SOURCE National Minority Quality Forum
Copyright©2009 PR Newswire.
All rights reserved

Related medicine news :

1. Arterial disease of the leg frequently overlooked in patients with heart disease
2. Automated Calls May Help Doctors Monitor Patients
3. Study finds higher drug co-pays discourage patients from starting treatment
4. Cardiac patients trial home-based rehabilitation
5. Barriers to Health Care, Prescription Choice Hurt Patients, Leading Doctor Says
6. Sustaining Excellence in All Aspects of Cardiac Care Rare But Lives Could Be Saved If More Patients Were Treated at Top-Performing Hospitals
7. Nations Substance Abuse Problem Will Be Solved Only if Patients Are Given Same-Time, Same-Place Access to Mental Health Services, Says Leading Expert
8. A New, Highly Effective, Non-Narcotic Pain Medication Now Available for Chronic Pain Patients
9. New Data Presented at AUAs Annual Conference Prove GELNIQUE(TM) (oxybutynin chloride) 10% gel is an Effective, Safe Option for Female Overactive Bladder (OAB) Patients
10. Patients at community health clinics less likely to be referred to cardiologist
11. Consumers Union Report: Almost 100,000 Surgical Patients Didnt Get the Right Infection Prevention Care During Year Studied
Post Your Comments:
(Date:11/30/2015)... ... November 30, 2015 , ... According to Los Angeles bariatric surgeon ... are not necessarily caused by real hunger, but instead by a hormone called ... notes that, while many patients are aware that weight loss surgery can help patients ...
(Date:11/30/2015)... ... November 30, 2015 , ... RoamRight, a leading provider of ... Public Television’s Travel With Kids to promote family vacations around the world. ... they explore international destinations and educate families about the people and places of the ...
(Date:11/30/2015)... ... 2015 , ... At Grand Dental PC, their priority is to deliver quality ... dental problems, you need to turn to a dentist who listens and responds; an ... a friendly dentist who counsels you on the best ways to maintain and improve ...
(Date:11/30/2015)... ... 30, 2015 , ... Newly reviewed and approved “NJ Top ... He has both advanced training and considerable experience in reconstructive dentistry with ... in cosmetic dentistry. He is an active Spear Education member providing full ...
(Date:11/30/2015)... ... November 30, 2015 , ... ”Dying Words: The AIDS Reporting of Jeff Schmalz ... 2015, to coincide with World AIDS Day. The multi-media project will be in audio ... epidemic as he was dying of the disease. , A collaborative effort led by ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... November 30, 2015 global cell culture market ... bn to US$11.3 bn by 2022 at a CAGR of 7.1% ... to grow from its 2013 value of US$6.1 bn to US$11.3 ... Transparency Market Research has announced the release of a new ... the report, titled ,Cell Culture Market - Global Industry Analysis, Size, ...
(Date:11/30/2015)...   Royal Philips (NYSE: PHG ... MRI guided user interface and automatic scan parameter selection ... Conditional implants, such as knee and hip replacements, spine ... of North America Annual Meeting (RSNA) . The new ... of this growing patient population. ScanWise Implant adds to ...
(Date:11/30/2015)... RATON, Fla. , Nov. 30, 2015   ... (the Institute) announced today that it has finalized ... device start-up company with technology developed at Florida State ... publicly-funded research, and bridges early funding gaps for companies ... and research institutions. --> ...
Breaking Medicine Technology: