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American College of Physicians

ACP: Federal, state laws limit better care


By Ashok Selvam
Posted: August 8, 2012 - 12:15 pm ET
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A paper released by the American College of Physicians highlights state and federal laws that it says limit physician-patient communication and present roadblocks to better care.

The paper, “Statement of Principles on the Role of Governments in Regulating the Patient-Physician Relationship”, suggests guidelines for the role of governments. Among the concerns are that some laws prevent physicians from educating patients about risk factors that could affect their health or their families', as suggested by evidence-based guidelines of care. The paper also outlines worries that physicians are mandated to discuss specific practices that aren't in the physicians' best clinical judgment for the individual patients' care.

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“The physician's first and primary duty is to put the patient first,” said Dr. David Bronson, president of the ACP, in a news release. “To accomplish this duty, physicians and the medical profession have been granted by government a privileged position in society.”

The study mentioned a law in Alaska that allows a patient or patient's family to override a physician's do-not-resuscitate order. Other laws referenced included one in Arizona, where a woman must have an ultrasound within 24 hours of having a mammogram, and one in Florida, where doctors are prevented from asking patients questions pertaining to gun safety or recording that information on the patient's medical record.

The ACP suggests lawmakers ask seven questions before pursuing healthcare-related legislation. Those queries include asking if a proposed law is needed to achieve public health goals that directly affect both an individual patient's health and population health and if that legislation is supported by scientific evidence. If it is, the ACP says that lawmakers should ask if there are any other reasonable ways to achieve the same goals.

The ACP's Health and Public Policy Committee produced the paper, with an assist from their Ethics, Professionalism and Human Rights Committee.


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