Commentary
Ob.gyn. leaders from across the country have issued a strongly worded policy statement telling lawmakers to stop interfering in the physician-patient relationship and calling on doctors to speak out against legislative overreaching.
On June 7, the executive board of the American College of Obstetricians and Gynecologists and the American Congress of Obstetricians and Gynecologists said that laws that require physicians to give or withhold specific information when counseling patients or that mandates the tests, procedures, and treatments that physicians can offer are "ill advised."
"Absent a substantial public health justification, government should not interfere with individual patient-physician encounters," the executive board wrote.
Dr. Jeanne A. Conry
ACOG offered some examples in which they said state legislators have intruded into medical practice with laws that:
• Require medically unnecessary ultrasounds before an abortion and force a patient to view the ultrasound image.
• Prohibit physicians from speaking to patients about firearms and gun safety.
• Mandate an outdated treatment protocol for medical abortion.
• Prescribe what must be communicated to patients about breast density and cancer risk.
While many of the laws in questions affect women’s health, this is an issue that affects all patients and all physicians, said Dr. Jeanne A. Conry, president of the American Congress of Obstetricians and Gynecologists.
For instance, in Pennsylvania, physicians are restricted in what they can tell patients about their chemical exposure from the natural gas extraction practice called fracking. Under the law, physicians can access information about the proprietary chemicals used, but are barred from sharing the information with patients. "Help me understand that one," Dr. Conry said.
The trend toward greater legislating of medical practice has resulted in "disbelief and frustration" among physicians, Dr. Conry said. "It’s an insult to the intelligence of our patients, and it’s an insult to the intelligence of the provider."
The ACOG statement isn’t the first time that organized medicine has rebelled against these types of laws. In October 2012, leaders at ACOG, the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics, and the American College of Surgeons wrote a joint editorial opposing the intrusion of lawmakers into medical encounters (N. Engl. J. Med. 2012;367:1157-9).
But since that editorial was published, little has changed. It actually seems to be getting worse, Dr. Conry said.
So ACOG is also issuing a call to action to its members. Dr. Conry said ob.gyns. need to talk to lawmakers and patients to reverse this trend.
"Physicians have to view themselves as the leaders that they are," she said. "I think we use the ostrich approach. We put our heads in the sand all too often."
m.schneider@frontlinemedcom.com
On Twitter @MaryEllenNY