Wednesday, March 3, 2010

Amerling: The Threat to Physician Autonomy

Dr. Richard Amerling highlights an often under-appreciated aspect of ObamaCare -- namely that it will severely limit physician autonomy in the name of "practice guidelines", thus compromising the doctor-patient relationship.

Here's an excerpt from his article, "The Threat to Physician Autonomy":
Whatever its final form, ObamaCare... will include enhanced measures to control medical care. These will be implemented under the guise of quality assurance and cost containment. Slipped into the so called stimulus bill passed last February is a new federal health care panel that will decide which procedures and drugs are "medically necessary" and "cost effective." Based on the writings of Ezekiel Emmanuel, brother of Rahm and close Obama health advisor, we can assume rationing of care to the elderly (over 65!) and very young (under 2). Also included is a mandate for adoption of electronic health records (EHR). The clear goal here is to have access to every medical interaction; the only rationale for gathering such detailed information is to exercise control over medical decision-making.

The mechanisms are already in place. For the past couple of decades medical specialty societies, aided and abetted by the government, the American Medical Association, and Big Pharma, have been crafting clinical practice guidelines. These mostly opinion based recommendations will be transformed into mandates, first as "clinical performance measures," then as "payment for performance." Treatment algorithms will be built into the EHR to guide decision making at the point of service. Such a "one size fits all" approach will be an unmitigated disaster for patients.
(Read the full text of "The Threat to Physician Autonomy".)

In other words, doctors can treat the patient anyway they want -- as long as it's according to government-approved guidelines, and under the watchful eye of the government. If your needs fall outside of those guidelines, then tough.

Do Americans really want that kind of medical care?