March 2000 • Volume 6 • Number 3
• Grassroots Advocacy •
Advocacy: Dangerous to patients' health?
Patient advocacy can be flat-out wrong. Sometimes patients turn up the pressure, seeking care they may not need.
For example, Karen Johnson of Louisville, Ky., sued Humana Health Plan for not covering the hysterectomy her doctor advocated. She won a $13 million verdict in 1998; Humana said it would appeal.
"From what was published about this case, it appears the patient didn't need a hysterectomy. She probably only needed conization of the cervix," says Thomas Felger, M.D., of Fort Wayne, Ind., a member of the AAFP Commission on Health Care Services.
He has not heard of patients being denied care they clearly needed. At medical meetings, when physicians have complained about tight-fisted HMOs, he has asked for specific examples and has gotten no response.
Some legislatures have gotten into medicine and have required the coverage of autologous bone marrow transplants after high-dose chemotherapy for metastatic breast cancer.
That disturbs AAFP President-elect Richard Roberts, M.D., J.D., of Madison, Wis., who says the transplants result from the myth that doing more is doing better.
He adds, "Worse than no hope is false hope."
Roberts serves on the Blue Cross Blue Shield Association Technology Evaluation Program. "Our BCBS panel spent 10 years saying autologous bone marrow therapy doesn't work," he says. "States have mandated it. And you know what? It doesn't work."
FP Report is published by the AAFP News Department.
Copyright © 2000 by American Academy of Family Physicians.
FP Report | Headlines |AAFP Home | Search