An article in the Sunday Boston Globe really bothered me. In “Hippocritical” Doctors, an OB attacked physicians who work for health plans. He was unhappy that they didn’t make the health plan pay for all the therapy he wanted for his daughter with cerebral palsy:
This doctor and others like him are making money denying care â€“ and they might as well hang up their white coats. They may believe that their administrative decisions are medically justifiable. However, it often appears that they are hired because their MD degrees lend a patina of legitimacy to administrative decisions that are based on interpretation of a health planâ€™s policies, not a chart, lab test, or CT scan…
A physician who works for the health insurance industry told me that these doctors view themselves as having â€œan advocacy role for patient care.â€ Health plan physicians will argue that without them consumers would have no voice within the companyâ€™s walls. But I say let the businesspeople be the ones to withhold care in the name of cost savings and profit margins. Physicians are needed in the clinic and at the bedside, advocating for more care, not less.
The author shrugs off other physicians’ financial relationships with drug companies and banks, because they just damage society, “not… individual patients.”
I think the author is way off base. Remember the earlier days of managed care when doctors complained, sometimes legitimately about “being told how to practice medicine by someone from the HMO with a GED”? Isn’t it better to have a physician to speak with? Meanwhile, contrary to his statement, it doesn’t always make sense for the patient to get “more care.” It can be expensive and wasteful.
I sympathize with the author, who wants what’s best for his daughter, but health plan physicians don’t deserve the abuse he dishes out.March 29, 2007