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AMA to study referrals within health systems

NEWS IN BRIEF — Posted July 11, 2005

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The American Medical Assn. will take a hard look at referrals within integrated health systems and might recommend new policy, legislation or regulations based on findings.

Delegates at the AMA Annual Meeting in June called for a study to see if there are anti-competitive or ethical implications to the expectation that referrals stay within an integrated health system's physician group, whether or not those expectations are explicitly communicated or rewarded.

The study will focus on situations in which there is a choice among equally competent, competing physicians, and the choice is not inhibited by insurance coverage restrictions.

Delegate Steven Kanig, MD, a nephrologist from Albuquerque, N.M., said such expectations could force physicians employed by the systems into a conflict of interest, and therefore an ethical jam. But the situations also can raise legal issues because of concerns about anti-competitive behavior.

Dr. Kanig, whose New Mexico delegation introduced the proposal, said the resolution was not intended to try to put a stop to physician referrals within integrated systems. "It is intended to stimulate development of guidelines," he said.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/07/11/bibf0711.htm.

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