Tuesday, September 4, 2012

Physicians and Legislators Defend Doctor-Patient Relationship

Dr. Neavel
Yesterday’s public hearing on how the Texas Women’s Health Program (TWHP) will function without federal funding saw doctors and legislators speak up for the well-being of Texas women and the doctor-patient relationship.

Celia Neavel, MD, FSAHM, warned the Texas Department of State Health Services (DSHS) that its proposed rules, if implemented, would restrict a physician's ability to provide candid and confidential information about elective abortions to any woman seen in the practice, even if the physician felt this information was in the best clinical interest of the patient or if the patient asked about the procedure. "The rules set a dangerous precedent for future interference by lawmakers in patient-physician communication, based upon the political agenda of the day," Dr. Neavel said. Her clinic, People's Community Clinic in Austin, will reluctantly resign from the program if the rules are adopted.
Dr. Realini

"We are alarmed by the proposed Women's Health Program rules because they will discourage provider participation and limit women's access to care," said Janet Realini, MD, president of Healthy Futures Alliance (HFA), a coalition dedicated to reducing teen and unplanned pregancy. "Members of HFA are already seeing a real crisis in access to women's preventive care. Further loss of providers will only make things worse."

Dr. Realini outlined her concerns to DSHS officials:
  • TWHP is critically important to the health of Texas women and families. The program keeps women and babies healthy, and reduces Medicaid costs to taxpayers.
  • A recent two-thirds funding cut to TWHP has cut off at least 150,000 women from preventive care and is creating a crisis in Texas communities.
  • There are too few TWHP physicians to meet the current need, and the proposed rules will mean even fewer doctors. 
Dr. Realini urged DSHS to drop what Texas physician organizations call the “gag order” in the TWHP proposed rules to maximize the number of physicians who can provide care to low-income women in Texas.

Joining Drs. Neavel and Realini were Reps. Donna Howard (D-Austin) and Sarah Davis (R-Houston), and Sen. Kirk Watson (D-Austin). They told DSHS the rules will further erode physician participation in TWHP at a time when Texas already has too few doctors and clinics serving these patients. The legislators cited the Texas Medical Association’s letter to DSHS officials, which states: "Physicians will not sacrifice their medical ethics and professional standards to participate in a program that imposes such draconian restrictions.”

"Few relationships are as sacred as the doctor-patient relationship," Representative Davis wrote in the letter to Health and Human Services commissioner in August. "I have been an outspoken critic of any legislation that interferes with this relationship, and oppose any rules that are ambiguous enough to prevent a doctor from sharing his or her best medical advice with a patient."

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