Monday, April 14, 2014
Professional Independence
Professional independence has long been a strong element of
the culture of health care generally and of the medical profession in
particular. “Following doctor’s orders”
was something good patients did and nobody wanted to be accused of “interfering
in the practice of medicine.”
That now seems to be in a state of demise.
The April 8 issue of The Boston Globe carried an article
about cutbacks in painkiller prescriptions by Massachusetts Blue Cross Blue
Shield. The key sentence reads “Faced
with concerns about a rise in opiate abuse, Blue Cross implemented changes in
July 2013 that have reduced prescriptions by 20 percent for common opioids such
as Percocet and 50 percent for longer-lasting drugs such as Oxycontin….” The changes were limits on the number of
days’ supply per prescription and the number of refills eligible for payment. Prior authorization by Blue Cross was also
required in some cases.
As I read through the article my thought was that either
some bad medicine was being practiced or Blue Cross was interfering in doctor
business. If the former, somebody would
“view with alarm.” If the latter,
somebody representing the profession would complain.
Neither turned out to be the case. Instead Dr. Raymond Dunlap, president of the
Massachusetts Medical Society was reported as saying that “Blue Cross is
heading in the right direction.”
It looks as if the day is coming when the professional
independence of medicine will be a thing of the past. Doctors who wonder how that happened need
only look in the mirror.
