Opinion

If doctors are rated, then patients must promise to follow instructions

LETTER — Posted April 11, 2005

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Regarding "Tiered physician network pits organized medicine vs. United" (Article, March 7): It will be an uphill battle to fight insurers who rate doctors on the basis of quality as a subterfuge for economic profiling if we don't think outside the box. Under this system, should doctors ask patients to sign a formal contract to follow instructions for follow-up, consultations, testing, etc., or face dismissal from our practice?

Perhaps the day will come when patients' "credentials" are rated and reviewed before a doctor will accept them. It's sad to say, but the sickest patients, along with the most noncompliant ones, might find it hard to get care in a system set up to save the insurer and the patient a buck. Now is a good time for doctors to consider this option to send a message to insurers and patients alike rather than wait to be abused further by the system.

Rosario Romano, MD, Port Jefferson Station, N.Y.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/04/11/edlt0411.htm.

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