Preauthorization ploy promises safety and savings but delivers hassles

LETTER — Posted Dec. 6, 2004

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Regarding "Tightening the leash" (Article, Oct. 18): Before physicians and the AMA invest their entire focus and energies on tort reform as the most urgent issue confronting medicine, we should reread the article cited above to remind us that our long-term battle is as much, if not more, with the private insurers as it is with malpractice attorneys.

We have prior authorization programs for medication and now for diagnostic imaging. Compliance requires our time, and a lot of it, during our working day. That time translates to lost income for physicians, transferred from our wallets directly to utilization management firms that tout their ability to lower private insurers' imaging expenses. We can expect only further intrusive oversight programs disguised and marketed to payers and patients as premium savings and safety measures.

We must regain control over our practices. The AMA and the state societies must vigorously support us on issues like this. There's much more to the difficult situation physicians find themselves in than just tort reform.

Michael E. Miller, MD, Boston

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/12/06/edlt1206.htm.

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