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The ignorance required to think at this level of arrogance is, I
admit, at first repugnant and discouraging. It would effect far
more
than pregnant women in its scope of tyranny. But, those of us who
look to see the end in the beginning can visualize the outcome and
may want to reconsider opposing such a resolution. I foresee
people
researching their own conditions and avoiding MDs whenever possible
and seeking alternatives first, so as not to be put in the position
of needing to disagree with a control mongering doctor. This may
well improve the health of the general public and the health insurance
industry.
Being blinded by arrogance prevents the ability to see the natural
outcome of such an effort. There is an unavoidable outcome
inherent
in such a plan that is purely poetic in its ultimate
justice: If a
list of ‘ungrateful’ patients is collected and published, it will
also provide us with a data base from which we can identify the
doctors with the most dissatisfied patients. Perhaps we should
simply allow them to weave the rope with which they will hang
themselves. Once they realize how labeling a patient will
ultimately
label themselves, they will be the ones living in fear of their own
terrorism! Insurance companies will have a list of doctors that
tend
to over-drain the system and will know who to keep a close eye upon!
This may be one of the best plans they’ve ever come up with.
Perhaps, we should all send them a message telling them what a great
idea this is. Of course, that may actually inspire them to
reconsider starting a war they cannot possibly win.
In the words of
found that those who attempt to paint a dark background just make it
easier to distinguish where the light is and causes the colors to
stand out more brightly. That is why we only see stars at night!
And, by the way, as a patient, I expect to be treated as the
employer, not a ‘competent partner’. I may not have been to
medical
school, but if a doctor can understand it, so can I. I pay him to
assemble the relevant information and advise me so that I am
comfortable making my own health decisions. I am the one who will
have to live with those decisions. The doctor only has to live
with
the decision he/she makes for me. In that case, I am likely
unconscious, in an emergency room, have no way of choosing who is
treating me, and am no one's 'partner'. When I am able to, I am
careful to choose a competent physician. I consider respect,
humility, caring, and kindness to be at least as important as medical
education when assessing a physician’s competence. But, I never
forget that the doctor works for me and can be fired. What we
might
want to do is suggest that MDs start their own list of practitioners
who do not label their patients so the public will be better able to
identify respectful doctors. Can you imagine mechanics or other
professionals taking on an authoritarian attitude and trying to
strong arm us into accepting unnecessary or harmful services by
threatening to black-list us. We would not allow it.
Terrorism only
works if we choose to live in fear.
From:
MCCFHC@yahoogroups.com [mailto:MCCFHC@yahoogroups.com] On Behalf Of MCC-FHC
Sent: Friday, June 12, 2009 9:27
PM
To: MCCFHC@yahoogroups.com
Subject: [MCC-FHC] Fwd: [fomm_stl]
AMA Resolution Would Seek to Label “Ungrateful” Patients
---------- Forwarded
message ----------
From: Lily Beck <international@
Date: Fri, Jun 12, 2009 at 8:36 PM
Please blog about this and distribute far and wide!
http://ican-
*AMA Resolution Would Seek to Label “Ungrateful” Patients*
*
(AMA) Annual Meeting next week, delegates will vote on a resolution which
proposes to develop CPT (billing) codes to identify and label
“non-compliant” patients (1) <http://www.ican-
The resolution complains:
*“The stress of dealing with ungrateful patients is adding to the stress
of physicians leading to decreased physician satisfaction.”
*
“This resolution is alarming in its arrogance and its failure to recognize,
or even pay lip service to, patient autonomy,” said Desirre Andrews, the
newly elected president of the International Cesarean Awareness Network
(ICAN).
If approved, the resolution could hold implications for women receiving
maternity care. For pregnant women seeking quality care and good
outcomes,
“non-compliance” is often their only alternative to accepting sub-standard
care. Physicians routinely order interventions like induction,
episiotomy,
or cesarean section unnecessarily.
Liz Dutzy, a mother from
cesarean and was told by her obstetrician that she needed another surgical
delivery. “My doctor told me that I needed to have a cesarean delivery at
39 weeks, or my uterus would rupture and my baby would die.” She sought
out
another care provider and had a healthy and safe intervention-
birth at 41 weeks and 3 days gestation.
A recent report by Childbirth Connection and The Milbank Memorial Fund,
called “Evidence-Based Maternity Care: What It Is and What It Can Achieve ,”
(2) <http://www.ican-
in the
heed evidence-based care practices. For most women in the
practices that have been proven to make childbirth easier and safer are
underused, and interventions that may increase risks to mothers and babies
are routinely overused. The authors of the report point to the “perinatal
paradox” of doing more, but accomplishing less.
The resolution proposed by the
patient care and patient autonomy for several reasons:
• Billing codes that would categorize any disagreement and exercise of
autonomy on the part of the patient as “non-compliance” “abuse” or
“hostility” could create a pathway for insurance companies to deny
coverage
to patients
• Use of these labels fails to recognize patients as competent partners with
physicians in their own care
• Tagging patients as “non-compliant” fails to recognize that there is not a
“one size fits all” approach to care, that different opinions among
physicians abound, and that patients are entitled to these very same
differences of opinion
• Labeling patients as “non-compliant” may, in fact, be punitive,
jeopardizing a patient’s ability to seek out other care providers
The resolution also fails to address how it would implicate patients
navigating controversial issues in medical care, like vaginal birth after
cesarean (VBAC). While a substantive body of medical research
demonstrates
that VBAC is reasonably safe, if not safer, than repeat cesareans, most
physicians and hospitals refuse to support VBAC.
(3)<http://www.ican-
suggests that patients who assert their
right to opt for VBAC could be tagged as non-compliant, even though their
choice would be consistent with the medical research.
“The reality is that the balance of power in the physician-patient
relationship is decidedly tipped towards physicians. The least patients
should have is the right to disagree with their doctors and not be labeled a
‘naughty’ patient,” said Andrews.
*About Cesareans: When a cesarean is medically necessary, it can be a
lifesaving technique for both mother and baby, and worth the risks
involved. Potential risks to babies from cesareans include: low birth
weight, prematurity, respiratory problems, and lacerations. Potential
risks
to women include <http://ican-
infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous
placental abnormalities in future pregnancies, unexplained stillbirth in
future pregnancies and increased percentage of maternal death.
improve maternal-child health by preventing unnecessary cesareans through
education, providing support for cesarean recovery and promoting vaginal
birth after cesarean. ICAN has 110 chapters in North America and
which hold educational and support meetings for people interested in
cesarean prevention and recovery.*
(1) Resolution 710 “Identifying Abusive, Hostile or Non-Compliant
Patients”<http://www.ama-
(2) Evidence-Based Maternity Care: What It Is and What It Can
Achieve<http://www.childbir
(3) http://www.ican-
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