| |
 |
Frederick (Md.) News Post Op-Ed: Pharmacists pawns in health care's game of chess
by Howard Schiff, Executive Director of the Maryland Pharmacists Association
These days, the health care industry seems to function like one big game of chess. Each player, whether it be a provider, insurer or pharmacist, moves in a distinct way trying to protect their role in supporting the ultimate "king": the American patient.
Unfortunately there is one major difference between chess and the health care industry. Chess follows a code of conduct and ethics. One current player in the health care industry does not — health insurers.
If they did, pharmacists would not feel the enormous pressure from health insurers to place cost savings before a patient's health. Nor would they be asked to compromise themselves professionally in order to adhere to medication guidelines being mandated by health insurers, not the prescribing physician.
Welcome to our modern-day game of chess.
Our health care system has changed and pharmacists are playing at a handicap to insurance companies. Pharmacists do not just count pills. They are an integral partner in health care, and are working closely with patients and their physicians to dispense medicines that support medically appropriate, individualized treatment plans.
With this new role, the pharmacist now serves as the gatekeeper or "pawn" as to whether or not the physician's proposed treatment plan ever actually makes its way to the patient. You see, the pharmacist now has to work with two "prescribers": the patient's physician and the patient's insurance company.
Health insurers do not hold a degree in medicine, yet they're forcing pharmacists to dispense medications not initially prescribed by a patient's physician.
Enter the illegal move. In chess, a player who makes an illegal move must retract that move and make a legal move. This practice of medicine by insurers should also be retracted and be limited to providers who are professionally qualified to assess and protect the health of our patients.
The National Association of Boards of Pharmacy has come out in opposition of these insurer practices as they impose rules on patients and pharmacy providers that can be interpreted as the practice of pharmacy or medicine.
Specifically, insurers are routinely forcing pharmacists to deny and change medications that authorized prescribers feel are in the best interest of their patients. This practice is dangerous, because it interferes with the continuity of care of a patient's drug therapy, especially when those patients are already well-maintained on a medication regimen.
Remember, the game of chess follows a code of conduct; the health insurance industry does not. While health care providers and pharmacists are, and should be, held to a set of standards and ethical codes, we can only hope that as our health care system becomes more transparent. These insurance practices must be abolished to place patients before costs.
The American Medical Association is doing their part by developing a Health Insurer Code of Conduct that will be presented for a vote in June 2009 that will develop clear and concise principles to address medical care policies, payment issues and monitor compliance of health care insurers. Passage of this measure will help not only help the patient, but it will also preserve the role of the pharmacist in the midst of the ever-changing health care industry.
Howard Schiff is the executive director of the Maryland Pharmacists Association.
READ THE ORIGINAL ARTICLE
# # #
All News Items
August 26, 2010 - The Lund Report: The Best Care Possible: You're Worth It
June 14, 2010 - American Medical News: 10 things health insurers must do to regain trust; The AMA, with endorsement from 68 state and medical specialty societies, outlines steps health plans must take to be credible in the eyes of physicians and patients.
February 27, 2010 - Providence Journal: The creepy third person in doctor’s exam room
November 28, 2009 - Newport News Daily Press: MDs under attack
November 04, 2009 - The Hill: A code of conduct for health insurers
October 27, 2009 - WCBU-FM 89.9 (Peoria, Ill.) radio news
October 26, 2009 - WEEK (NBC - Peoria, Ill.): Developing a doctor-patient relationship
October 12, 2009 - Las Vegas Business Press: Here's a prescription: A health insurers code of ethics
September 09, 2009 - Maryland State Medical Society Resolution 14-09
August 29, 2009 - The Island Packet: AMA code puts doctors, patients in charge of care
August 28, 2009 - Baltimore Times: Group calls on health insurers
August 27, 2009 - Baltimore Times: Nursing Maryland back to health
August 20, 2009 - Lincoln Journal-Star: Pharmacists forced to serve insurers rather than patients
August 19, 2009 - WSTM-NBC3: Prescription medication battle heats up in Central New York
August 17, 2009 - New York State Senator Jeffrey D. Klein blog: For Health or Profit? Klein Unveils Sickly Scorecard of Major HMOs
August 17, 2009 - New York Daily News: Prescription Prescription drug coverage marred by bureaucracy, survey says
August 13, 2009 - Leading African American Groups Call On Health Insurers to Dismiss Restrictive Practices
August 13, 2009 - San Diego Union-Tribune: Bureaucracy won't contain costs
August 01, 2009 - Huntington, W.V. Herald-Dispatch: Insurers put stress on the physician-patient relationship
July 21, 2009 - Chicago Tribune: They authorized back surgery but denied his $148,000 claim
July 17, 2009 - American Osteopathic Association calls for Development of Code of Conduct
July 12, 2009 - Houston Chronicle: Another kind of remedy for the sick; Code of conduct would protect patients
July 07, 2009 - Washington Post: Health Reform: Who Holds the Reins on Care?
July 06, 2009 - NATIONAL HEALTH INSURER CODE OF CONDUCT HITS 1000 SIGNATURES OF SUPPORT
June 30, 2009 - Atlanta Journal-Constitution: Code of conduct needed for health insurers, too
June 24, 2009 - Penn. Pharmacists Association: “A Patient Walks Up to the Counter …”
June 24, 2009 - Pittsburgh Post-Gazette: Broken bonds; The physician-patient relationship is being destroyed by the cost-driven decisions of health insurers
June 09, 2009 - Bellingham (Wash.) Herald: Time for a health insurance code of conduct
June 08, 2009 - Mississippi Business Journal: Transparency is the best medicine; Health Insurer Code of Conduct may improve the quality of care
June 03, 2009 - Frederick (Md.) News Post Op-Ed: Pharmacists pawns in health care's game of chess
June 01, 2009 - KUSI-TV interview with Dr. Jack Schim
May 25, 2009 - San Francisco Chronicle: Doctor pushes back against insurer scrutiny
May 08, 2009 - Fox News Health Blog: Bad Medicine: Is Your Insurance Company Hazardous to Your Health?
April 27, 2009 - Petition for Health Insurer Code of Conduct Garners Widespread National Support
April 20, 2009 - On-line petition launched in support of a national health insurer code of conduct
April 13, 2009 - Petition launched in support of a national health insurer code of conduct
April 09, 2009 - Westchester (N.Y.) Herald letters: Access to Quality Healthcare
April 01, 2009 - Los Angeles Society of Allergy, Asthma & Clinical Immunology Applauds the AMA for Developing Health Insurer Code of Conduct
March 24, 2009 - Arizona Republic: Patient care, not financial gain, must take priority
March 22, 2009 - Rochester (N.Y.) Democrat and Chronicle: Health insurers should agree to a code of conduct
March 20, 2009 - Buffalo News: Code of conduct would protect patients from insurers
March 10, 2009 - AfPA Launches Petition in Support of a National Health Insurer Code of Conduct
March 09, 2009 - Texas Medical Society: Health Insurance Code of Conduct Act of 2009; The Time Has Come
March 09, 2009 - American Medical News: MSSNY president: Insurer settlements highlight need for code of conduct
February 01, 2009 - Colorado Medicine: Health Insurer Code of Conduct?
January 24, 2009 - Fresno Bee: Doctors push code of conduct for insurers
December 10, 2008 - Lupus Agencies of New York State Applaud AMA's Resolution to Develop a "Code of Conduct" for Health Insurers
December 09, 2008 - New York State Rheumatology Society Position Paper: AMA Resolution 823
November 20, 2008 - National Minority Quality Forum Applauds AMA's Health Insurer Code of Conduct
November 14, 2008 - Alliance for Patient Access Applauds AMA's Health Insurer Code of Conduct
November 13, 2008 - Alliance for Better Medicine Calls on California Health Insurers to Adopt a "Code of Conduct"
November 13, 2008 - Los Angeles County Medical Association Reinforces AMA's Call for a Health Insurer Code of Conduct
|
|
This website is a project of the Alliance for Patient Access.
 |
|
|
|
