KAISER PERMANENTE: Under Investigation for Unethical Drug Prescriptions
Kaiser Permanente, California's largest HMO, is under investigation by the state Department of Corporations for allowing its doctors to routinely prescribe psychiatric drugs without personally examining the patient. Instead of interviewing the patients themselves, doctors in the Kaiser Permanente plan defer to psychologists or social workers, and in some cases a social work intern. Sparking the investigation is a lawsuit filed by Dr. Thomas Jensen, a former Kaiser Permanente physician. Jensen was fired by the HMO for refusing to follow the company's policy. He said, "I was astounded that this was happening. I was trained that you don't prescribe medicines for patients you've never seen." Dr. Joseph Coyle, chair of Harvard Medical School's department of psychiatry, agreed, saying, "It's not trivial to put someone on psychotropic medications. If you haven't evaluated the patient when you start the treatment, then it's impossible to follow the patient and see how (he or she) is responding. ... I'm surprised that an ethical insurer would require such a practice." But Dr. Dennis Cook, coordinating chief of psychiatrists for the HMO's Southern California area, defended the policy, saying it "allowed Kaiser's psychiatrists to see more patients by eliminating a potentially duplicative initial interview." He said, "We think it's very ethical." Kasier Permanente has 30 days to respond to the allegations in Jensen's suit. Both California law and the American Psychiatric Association code of ethics declare that prescribing medications without a prior "good faith" examination constitutes unprofessional conduct (Maharaj/Bernstein, Los Angeles Times, 4/12).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.