Summaries of several recent developments related to physicians and the medical profession appear below.
Patient lies: Lies patients tell physicians can "lead to expensive diagnostic procedures and unneeded referrals to specialists" and have "disastrous results," the AP/Tacoma News Tribune reports. Patients often lie to physicians about their smoking, drinking and exercise habits, as well as whether they take prescribed medications. According to a recent study conducted by researchers from the Johns Hopkins School of Medicine, 73% of patients told physicians they used their inhalers three times daily as prescribed, although only 15% used their inhalers that often (Johnson, AP/Tacoma News Tribune, 2/16).

Quality-of-care programs: "Many physicians are suspicious of insurers' motives, and some are fighting" programs under which health insurers rate the physicians based on the quality of care they provide, the AP/Washington Times reports. UnitedHealth Group, Cigna, Aetna and WellPoint use such programs. Some physicians maintain that such programs only apply to claims filed by patients -- "information they say only tells half a story," the AP/Times reports. However, according to health insurers, such programs use a combination of data to determine the quality of care provided by physicians. Jeffrey Kang, senior vice president and chief medical officer at Cigna, said, "We believe consumers should have information and access to all their doctors, but we want to (give them incentives) to go to high-quality providers." Jim Rohack, a cardiologist and board member of the American Medical Association, said, "We're concerned that as insurers try to maximize profits, they are saying that the doctor that charges the least amount of money is the highest quality" (Agovino, Washington Times, 2/20).

UnitedHealth: Some new policies implemented by UnitedHealth have prompted concerns from certain physician groups, USA Today reports. UnitedHealth last year signed a 10-year, $3 billion contract with the Laboratory Corporation of America. Under the contract, all UnitedHealth members must have their tests performed at LCA labs, and physicians who refer patients to other labs could have to pay fines or leave the network. According to USA Today, some physicians maintain that "patients may have to go farther for tests" as a result of the contract. In addition, UnitedHealth in August 2006 ended a "facility fee" paid to gastroenterologists who performed procedures in hospitals or ambulatory surgery centers and increased payments to those who perform procedures in their offices. Edward Cattau, chair of the national affairs committee for the American College of Gastroenterology, said that gastroenterologists should have the ability to decide where they perform procedures (Appleby, USA Today, 2/19).

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