If this guy is leading the revolution we are in serious trouble

If this guy is leading the revolution we are in serious trouble

A week ago the Boston Globe printed an article about a physician practicing “guerilla tactics” to circumvent insurance company restrictions.

He said he has broken prescribing regulations about 10 times in the last six or seven years to avoid insurance company restrictions on various drugs.

His actions are an extreme example of widespread dissatisfaction among primary-care physicians, who say they are frustrated by increasingly restrictive rules imposed by health insurance companies in an effort to reduce healthcare costs.

“This is doctor resistance through guerrilla tactics,” said Arthur Caplan, chairman of the Department of Medical Ethics at the University of Pennsylvania. If insurers “are really putting the screws to your patients, you do have an advocacy responsibility, and that may mean cutting corners, or doing something deliberately wrong to get them what they need. Who wouldn’t want that person as their doctor?”

I thought the article was fine, and I do sympathize with a physician laboring to do what’s best for his patients. But his efforts are fairly ho hum in the scheme of things. And the alternative to insurance company quantity limits on drugs is higher premiums or a socialized system where expensive drugs aren’t covered at all.

Nevertheless, the Globe printed four letters–in two different sections of the newspaper no less!– extolling this physician’s virtues. Here are the headlines:

  • Physicians need to steer patient care
  • The way healthcare is supposed to be
  • Doctors at risk for doing what’s right
  • Doctors’ oath is to his patients, not health insurers

Defenders of the status quo can rest easy.

June 19, 2006

One thought on “If this guy is leading the revolution we are in serious trouble”

  1. Honestly, seems like this article should serve as one more “wake up call” to the U.S. Public – too many of the decisions about healthcare are being made by non-physicians (eg., insurance companies) whose sole interest is their own “bottom-line”. There is nothing wrong with forumlary restrictions for prescribing. For example, I bet that many physicians would actually endorse much stricter formulary restrictions for medicaid/medicare patients as part of an overall approach to reduce costs. However, any formulary that is developed would need to be physician-driven with an emphasis on allowing the most effective therapies to be prescribed.

    Any formulary, should be part of a system that easily allows physicians to “do the right thing” for their patients (re., prescribing) WITHOUT having to resort to “guerilla tactics”.

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