CMSS Supports NEJM Article on State Laws Interfering with the Practice of Medicine
January 17, 2013
Chicago, IL – The Council of Medical Specialty Societies (CMSS) has adopted a new policy opposing legislative interference with the practice of medicine and the patient-physician relationship. The CMSS Council endorsed the position outlined in the October 8, 2012 New England Journal of Medicine Sounding Board article titled, “Legislative Interference with the Patient-Physician Relationship.” The policy is based on the article co-authored by Steven Weinberger, MD, Executive Vice President and CEO, American College of Physicians; Hal Lawrence III, MD, Executive Vice President, American College of Obstetricians and Gynecologists; Douglas Henley, MD, Executive Vice President, American Academy of Family Physicians; Errol Alden, MD, Executive Director and CEO, American Academy of Pediatrics; and David Hoyt, MD, Executive Director, American College of Surgeons.
The article outlines the fundamental principles of respect for autonomy, beneficence, non-maleficence, and justice that dictate physicians’ actions and behavior and shape the interactions between patients and their physicians. The article continues to say that when physicians adhere to these principles, when patients are empowered to make informed decisions about their care, and when legislators avoid inappropriate interference with the patient-physician relationship, that physicians can best balance and serve the healthcare needs of individual patients and the broader society.
“Examples of inappropriate legislative interference with this relationship are proliferating, as lawmakers increasingly intrude into the realm of medical practice, often to satisfy political agendas without regard to established, evidence-based guidelines for care,” said Dr. Steven Weinberger, Executive Vice President and CEO of the American College of Physicians.
There are four specific types of laws or legislative proposals that are of particular concern. The first type of law prohibits physicians from discussing with or asking their patients about risk factors that may affect their health or the health of their families, as recommended by evidence-based guidelines of care. Second, some new laws require physicians to discuss specific practices that may not be necessary or appropriate at the time of a specific encounter with a patient, according to the physician’s best clinical judgment.
The third type of laws require physicians to provide patients with diagnostic tests or medical interventions whose use is not supported by evidence, including tests or interventions that are invasive and required to be performed even without the patient’s consent. And finally, there are laws limiting the information that physicians can disclose to patients, to consultants in patient care, or both.
“Federal, state, and local governments have long played valued and important roles in our nation’s health care,” said Dr. Hal Lawrence, Executive Vice President of the American College of Obstetricians and Gynecologists. “None of the concerns we raised in the article imply that we object to these government roles, but we believe that physicians must have the ability and freedom to speak to their patients freely and confidentially, to provide patients with factual information relevant to their health, to fully answer their patient’s questions, and to advise them on the course of best care without the fear of penalty.”
Founded in 1965, CMSS was created to provide an independent forum for the discussion by medical specialists of issues of national interest and mutual concern. Today, CMSS represents thirty-nine societies with an aggregate membership of 700,000 US physicians. Its main purpose is to provide a forum for collaboration to influence policy, medical education and accreditation from a broad, cross-specialty perspective. CMSS is the unified voice for specialty societies established to improve the United States’ healthcare system and health of the public. For more information, visit CMSS at www.cmss.org.