American Medical Association To Consider Supporting Legislation Restricting Where Doctors Can Work

The American Medical Association's Board of Trustees will recommend to the group's House of Delegates that it consider pushing for state or federal legislation to forbid corporations and hospitals from directly employing physicians, the Miami Herald reports. In a formal report, the AMA trustees noted that the group has a long-standing belief that it is unprofessional for doctors to work for organizations in which they could gain from profits. However, rising costs and lower reimbursements have forced many doctors to abandon small-group practices and seek employment at companies or hospitals, a trend that has raised concern among AMA trustees about the "general erosion of physicians' independence," according to the Herald.

Joseph Heyman, an AMA trustee, said, "[W]e don't want to have corporations or anybody using their concerns about finance to influence the relationship between a patient and a physician." He added, "We want the physicians to ... make the best choices for the patients." It is "not legislation that every state would necessarily have," Heyman said. However, executives at hospitals and physician employment firms said they do not instruct physicians on how to treat patients.

"We believe our physicians are well qualified to take care of patients," Roger Medel -- CEO of Florida-based Pediatrix, which specializes in the treatment of newborns in hospitals -- said. Stephen Desnick -- CEO of Sterling Healthcare, which focuses on emergency department care and employs 1,000 doctors -- said, "They're trying to put a genie back in the bottle that has been out for a long time." He added that the AMA is "just not in line with what's happening." The proposal will be heard by the AMA House of Delegates at its annual meeting in Chicago this month (Dorschner, Miami Herald, 6/10).

AMA also will consider at its meeting a proposal for the group to formally oppose FDA's decision to add a "black box" warning to antidepressants, advising physicians and consumers of the potential dangers of the drugs for teens (Japsen, Chicago Tribune, 6/9). In March, the labels for the five antidepressants most commonly prescribed to children began to include the warnings to advise consumers that the medications could cause suicidal tendencies in individuals younger than age 18. FDA ordered the warnings for antidepressants based on an analysis of 15 clinical trials that found a "consistent link" between the use of the medications and suicidal tendencies in children (California Healthline, 3/21).

Since FDA began its study of the potential link, use of antidepressants among children under age 18 has decreased more than 10%, according to a study by Medco Health Solutions. The American Psychiatric Association and other groups are concerned that the numbers show children are not receiving appropriate treatment for depression because their parents or physicians are deterred by the warning.

However, others expressed concern about the confusion that could result from "the nation's largest doctor's group" opposing FDA, particularly "during a time when the agency is under criticism for lax oversight of drug safety," according to the Tribune. Sidney Wolfe, director of Public Citizen's health research group, said AMA's proposal is "irresponsible and confusing." Pfizer and GlaxoSmithKline, which manufacture antidepressants, declined to comment (Chicago Tribune, 6/9).