How physicians not adhering to clinical guidelines may be punished
http://www.kevinmd.com/blog/2011/06/physicians-adhering-clinical-guidelines-p... ......" Government regulators and prosecutors will, of course, contend that they’re simply looking for “waste, fraud and abuse”, and that looking for non -adherence to guidelines is a reasonable screening tool when looking for criminals. But let’s not kid around. Any such policy is going to have a chilling effect on treating patients as individuals rather than statistically average widgets. You may need a test or procedure as a part of good medical care, but your doctor is going to be too scared to order it if her record of “guideline compliance” is at stake.Think about it. For the first time your doctor may have a real choice to make if your medical condition doesn’t happen to fit neatly into some academic cookbook. Adhere to the guideline and commit malpractice, or violate the guidelines and risk jail time.".....
Dr.Peikoff predicted this in the late 80's in his essay "Medicine:the Death of a profession" quoted here in his speech: Health Care Is Not a Right
http://www.afcm.org/hcinar2.html ...."I would like to clarify the point about socialized medicine enslaving the doctors. Let me quote here from an article I wrote a few years ago: "Medicine: The Death of a Profession." [The Voice of Reason: Essays in Objectivist Thought, NAL Books, © 1988 by the Estate of Ayn Rand and Leonard Peikoff.] "In medicine, above all, the mind must be left free. Medical treatment involves countless variables and options that must be taken into account, weighed, and summed up by the doctor's mind and subconscious. Your life depends on the private, inner essence of the doctor's function: it depends on the input that enters his brain, and on the processing such input receives from him. What is being thrust now into the equation ? It is not only objective medical facts any longer. Today, in one form or another, the following also has to enter that brain: 'The DRG administrator [in effect, the hospital or HMO man trying to control costs] will raise hell if I operate, but the malpractice
attorney will have a field day if I don't—and my rival down the street, who heads the local PRO [Peer Review Organization], favors a CAT scan in these cases, I can't afford to antagonize him, but the CON boys disagree and they won't authorize a CAT scanner for our hospital—and besides the FDA prohibits the drug I should be prescribing, even though it is widely used in Europe, and the IRS might not allow the patient a tax deduction for it, anyhow, and I can't get a specialist's advice because the latest Medicare rules prohibit a consultation with this diagnosis, and maybe I shouldn't even take this patient, he's so sick—after all, some doctors are manipulating their slate of patients, they accept only the healthiest ones, so their average costs are coming in lower than mine, and it looks bad for my staff privileges.' Would you like your case to be treated this way—by a doctor who takes into account your objective medical needs and the contradictory, unintelligible dema
nds of
some ninety different state and Federal government agencies ? If you were a doctor could you comply with all of it? Could you plan or work around or deal with the unknowable? But how could you not ? Those agencies are real and they are rapidly gaining total power over you and your mind and your patients. In this kind of nightmare world, if and when it takes hold fully, thought is helpless; no one can decide by rational means what to do. A doctor either obeys the loudest authority—or he tries to sneak by unnoticed, bootlegging some good health care occasionally or, as so many are doing now, he simply gives up and quits the field."....
http://www.kevinmd.com/blog/2011/06/physicians-adhering-clinical-guidelines-p... ......" Government regulators and prosecutors will, of course, contend that they’re simply looking for “waste, fraud and abuse”, and that looking for non -adherence to guidelines is a reasonable screening tool when looking for criminals. But let’s not kid around. Any such policy is going to have a chilling effect on treating patients as individuals rather than statistically average widgets. You may need a test or procedure as a part of good medical care, but your doctor is going to be too scared to order it if her record of “guideline compliance” is at stake.Think about it. For the first time your doctor may have a real choice to make if your medical condition doesn’t happen to fit neatly into some academic cookbook. Adhere to the guideline and commit malpractice, or violate the guidelines and risk jail time.".....
Dr.Peikoff predicted this in the late 80's in his essay "Medicine:the Death of a profession" quoted here in his speech: Health Care Is Not a Right
http://www.afcm.org/hcinar2.html ...."I would like to clarify the point about socialized medicine enslaving the doctors. Let me quote here from an article I wrote a few years ago: "Medicine: The Death of a Profession." [The Voice of Reason: Essays in Objectivist Thought, NAL Books, © 1988 by the Estate of Ayn Rand and Leonard Peikoff.] "In medicine, above all, the mind must be left free. Medical treatment involves countless variables and options that must be taken into account, weighed, and summed up by the doctor's mind and subconscious. Your life depends on the private, inner essence of the doctor's function: it depends on the input that enters his brain, and on the processing such input receives from him. What is being thrust now into the equation ? It is not only objective medical facts any longer. Today, in one form or another, the following also has to enter that brain: 'The DRG administrator [in effect, the hospital or HMO man trying to control costs] will raise hell if I operate, but the malpractice
attorney will have a field day if I don't—and my rival down the street, who heads the local PRO [Peer Review Organization], favors a CAT scan in these cases, I can't afford to antagonize him, but the CON boys disagree and they won't authorize a CAT scanner for our hospital—and besides the FDA prohibits the drug I should be prescribing, even though it is widely used in Europe, and the IRS might not allow the patient a tax deduction for it, anyhow, and I can't get a specialist's advice because the latest Medicare rules prohibit a consultation with this diagnosis, and maybe I shouldn't even take this patient, he's so sick—after all, some doctors are manipulating their slate of patients, they accept only the healthiest ones, so their average costs are coming in lower than mine, and it looks bad for my staff privileges.' Would you like your case to be treated this way—by a doctor who takes into account your objective medical needs and the contradictory, unintelligible dema
nds of
some ninety different state and Federal government agencies ? If you were a doctor could you comply with all of it? Could you plan or work around or deal with the unknowable? But how could you not ? Those agencies are real and they are rapidly gaining total power over you and your mind and your patients. In this kind of nightmare world, if and when it takes hold fully, thought is helpless; no one can decide by rational means what to do. A doctor either obeys the loudest authority—or he tries to sneak by unnoticed, bootlegging some good health care occasionally or, as so many are doing now, he simply gives up and quits the field."....
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