Public Health & Policy
In light of recently passed laws, the American College of Physicians (ACP) has released a statement of principles regarding the role of government in regulating the doctor-patient relationship.
The statement offers seven recommendations, including the notion that physicians shouldn't be barred from discussing risk factors with their patients, and that laws shouldn't mandate the content of what physicians can say to patients.
"The physician's first and primary duty is to put the patient first," ACP president David Bronson, MD, said in a statement, adding, however, that "some recent laws and proposed legislation appear to inappropriately infringe on clinical medical practice and patient-physician relationships, crossing traditional boundaries and intruding into the realm of medical professionalism."
Several states have proposed or enacted laws that prohibit doctors from asking their patients about risk factors, require them to provide tests that aren't supported by evidence, or limit the information they're allowed to disclose to patients.
Specifically, proposed legislation in Alaska would allow patients and families to override a physician's do-not-resuscitate order, and women seeking an abortion in Arizona must have an ultrasound at least 24 hours before the procedure.
Those seeking an abortion in Wisconsin must have three office visits with their doctor before the latter can prescribe a drug-induced abortion.
In Connecticut, Texas, and Virginia, physicians providing mammograms are required to notify women about their breast density and potential benefits of additional screening, according to the statement, and in Florida healthcare providers are prohibited from asking their patients questions about gun safety.
In Pennsylvania, physicians can access information about chemicals used during fracking -- the process by which oil and natural gas are extracted from rock -- but can't discuss their findings with their patients.
The ACP statement offers seven principles that should define the roles of state and federal government in healthcare and the patient-physician relationship, including:
- Physicians shouldn't be prohibited by law from discussing risk factors or disclosing information to the patient that may affect their health.
- Laws shouldn't mandate the content of what physicians may or may not say to patients
- Patients shouldn't be required to have tests or interventions that aren't medically necessary and aren't supported by scientific evidence.
The ACP warned against regulatory requirements that create undue burdens on physicians, limit access to care, or "unnecessarily divert from the precious time that physicians have to spend with patients."
Primary source: American College of Physicians
Source reference: Ginsburg J, Snyder L "Statement of principles on the role of governments in regulating the patient-physician relationship" ACP 2012.