2009-09-30 / Columnists

Survey shows that doctors feel pressured by health insurers to alter the way they treat patients

The Medical Society of the State of New York just released survey results, which indicate that health insurer rules often force New York State physicians to alter the way they treat patients – and not necessarily for the benefit of patients. Instead, the rules appear to have been developed to increase insurer profitsat the expense of the best health practices and patients’ health.

The survey, based on responses from more than 1,200 New York physicians, is carried in the September issue of News of New York, the medical society’s monthly publication. The survey results indicate: Ninety percent (90%) of the physicians sur­veyed said that they have had to change the way they treat patients based on re­strictions from an insurance company, and 92% said that insurance company incentives and disincentives regarding treatment protocols “may not be in the best interest of the patients.” Physicians’ most common complaint was that health insurers required them to change prescription medications; 93% of the physicians voiced this complaint. Over three-fourths (78%) said that an insurance carrier has restricted their ability to refer patients to the physicians they believed would best treat their pa­tients’ needs. A majority (87%) of physicians said that they sometimes feel that they are pressured to prescribe a course of treat­ment based on cost rather than on what may be best for the patient. Over half (62%) of the physicians surveyed, howev­er, are either somewhat concerned or very concerned (37% and 25% respectively) that they may be cut out of an insurance network if they do not follow the policies requested by insurance companies. Physicians overwhelmingly (95%) agreed that “Decisions on what medi­cations are right for a patient should be made by the patient’s own doctor and not by the health plan or the insurance carrier.” As a result, 91% of the doctors surveyed said that there should be en­forceable legislation to regulate the re­strictions that insurance carriers put on physicians in regard to treatment mo­dalities they prescribe for patients. Michael Rosenberg, MD, President of the Medical Society of the State of New York (MSSNY), said, “The survey was conducted as a result of the medical soci­ety receiving numerous complaints from member physicians that insurance car­riers were preventing them from giving their patients the most appropriate treat­ment for their patients’ particular health care needs. MSSNY, therefore, decided to poll all NYS physicians in all specialties to find out if the complaints were limited to just a segment of the medical profession or if they were representative of doctors in all specialties across the state. The complete survey results can be viewed on MSSNY’s website.

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