“GAG” CLAUSES: SHARP HEALTHCARE EMPLOYEE SPARKS DEBATE
A passage in the Sharp HealthCare System's newly releasedThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
employee handbook stating that "[a]ll employees have the
responsibility to place the interests of Sharp HealthCare above
their own and those of others" has "triggered heated debate" over
two pending patient rights initiatives in California, JOURNAL OF
COMMERCE reports. The debate centers on Proposition 216, the
Patient Protection Act, and Proposition 214, the Health Care
Patient Protection Act, both of which will appear on the state's
November ballot. The two measures, supported by the California
Nurses Association (CNA) and the Service Employees International
Union, respectively, "prohibit employee gag rules and physician
referral restrictions" by HMOs. The JOURNAL OF COMMERCE reports
that Proposition 216 co-author and consumer advocate Harvey
Rosenfield said the Sharp HealthCare handbook excerpt "stands as
the worst form of 'gag' order," adding that the message from the
company to the employees "inhibits worker rights to call
attention to inappropriate or inadequate medical treatment."
Rosenfield said, "These documents show that the health-care
industry's claim that gag orders do not exist are lies" (Lent,
FEAR AND LOATHING IN HMOs: According to the CNA, co-sponsor
of Proposition 216, the Sharp conflict of interest issue surfaced
when an anonymous nurse gave CNA the handbook, stating, "It's
clear that we can be terminated for any reason. The message is
we have to perform to [Sharp's] budgetary expectation, not the
expectation of patients and their families ... I am being stopped
from what I am trained to do." CNA President Kit Costello said,
"Provisions like this compromise the most fundamental
relationship in the health care process -- the trust between a
patient and their nurse or doctor" (CNA release, 7/16).
RESPONSE: Sharp HealthCare responded in a prepared
statement, "The clause from the Sharp employee handbook is part
of a lengthier and standard conflict of interest clause. In
intent and in practice, the conflict of interest statement
reminds employees to place the Sharp Mission of quality care
above self-interest, particularly personal financial gain. The
policy protects patients' rights to quality of care." Sharp
HealthCare added that "Conflict of interest statements similar to
the Sharp statement are common in the health care industry."
Sharp HealthCare is an integrated regional health care delivery
system based in San Diego that includes seven hospitals, three
medical groups and other facilities and services. The system
operates 1,955 beds, has 2,700 affiliated physicians and nearly
$650 million in assets (Sharp HealthCare release, 7/16).
MORE DETAILS: JOURNAL OF COMMERCE notes that about 17
million Californians, or 75% of the state's insured residents,
belong to managed care systems. It adds that by the year 2000
about 80% of the U.S. population will be covered by HMOs (7/22).