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Tags: insurance | medical imaging | healthcare politics

Once Again: Who Controls Medicine?

William Maxfield, M.D. By Tuesday, 17 March 2015 02:45 PM EDT Current | Bio | Archive

When I wrote my prior blog post, “Who Controls Medicine?” I had not fully realized the extent of current problem and the impact that it is having on the field.

Since then, I have had the opportunity to speak with a number of physicians, all of whom tell me that their offices are having significant difficulties getting insurance approval for the medications and procedures that they are prescribing for patients, even though in many cases those patients have been on the medications for some period of time. 

In talking with pharmacists, I find that there has been a major increase in the number of prescriptions that are delayed or denied by insurance companies, as well as an increase in the number that require prior approval — even though, once again, patients have been on the medications for a significant periods of time. 

I also have spoken with physicians in the imaging field who say that, for the first time in their careers, they are having insurance companies deny reimbursement for prescribed procedures. In fact, they say that it is becoming fairly common. 

What all of this means is that the practice of medicine is actually now being controlled not by doctors, but by insurance companies who have the ability to delay or deny approval for drugs and procedures. 

In my opinion, the need to obtain prior approval for prescriptions, and, more significantly, the disapproval of reimbursement for certain drugs and procedures is not authorized to insurance companies. It would seem that it is going to take some additional legislation to change these practices that are impinging upon the practice of medicine by physicians. 

I suggest that anyone who has had such a problem contact their state medical license board as well as the National Medicine Societies. This increasing infringement of insurance companies is preventing physicians from making the best medical practices available to patients. 

Any comments on this deteriorating situation would be appreciated. 

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Dr-Maxfield
When I wrote my prior blog post, “Who Controls Medicine?” I had not fully realized the extent of current problem and the impact that it is having on the field.
insurance, medical imaging, healthcare politics
322
2015-45-17
Tuesday, 17 March 2015 02:45 PM
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