American College of Physicians: Internal Medicine — Doctors for Adults ®

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Policy briefs

From the November ACP Observer, copyright © 2005 by the American College of Physicians.

College, others urge Congress to avert Medicare payment cuts

ACP has joined more than 120 other medical organizations in calling on Congress to avert the looming 4.4% Medicare payment cut for physicians that is set to take effect Jan. 1, 2006.

In an Oct. 3 letter sent to all senators and representatives, the organizations pointed out that if the January payment cut occurs, the physician payment rate in 2006 will be less than it was in 2001, even though practice expenses have risen sharply during that time.

The letter further cited results from an AMA physician survey, which found that 38% of responding physicians plan to reduce the number of new Medicare patients they accept if the pay cut goes into effect.

The letter also called on Congress to make necessary changes to the sustainable growth rate formula (SGR). The letter noted that other health care providers—such as hospitals and nursing homes—receive positive updates that reflect practice cost increases, while only physicians are subject to the SGR.

The letter is online.

ACP seeks support to retool, rescind payment formula

ACP is seeking help from two influential White House offices in its efforts to replace the sustainable growth rate (SGR) formula with a physician payment methodology tied to the actual costs of medical care.

Until the formula is replaced, ACP would like to see the SGR changed to make physician pay more equitable. In letters to top officials at the Office of Management and Budget and the National Economic Council, the College asked them to support requiring the Centers for Medicare and Medicaid Services to retroactively remove physician-administered drugs from the SGR formula calculation. The College made similar requests in 2002 and 2004.

Because the costs of physician-administered drugs have risen rapidly over the past several years, inclusion of such drugs in the SGR is a major reason why overall expenditures on services measured by the SGR have risen faster than the economy, resulting in projected across-the-board cuts in payments to physicians.

The letter is online.

Regents' Chair testifies on DTC ads

The Chair of ACP's Board of Regents told a Senate special committee on aging that Congress should strengthen Food and Drug Administration guidelines on direct-to-consumer (DTC) pharmaceutical advertising.


Dr. Sweet



In her Sept. 29 testimony, Donna E. Sweet, FACP, said the College has long opposed such advertising. She told legislators that marketing should be directed at clinicians, not consumers who can misinterpret the information.

She also said Capitol Hill must continue to fund studies to define and measure the impact of DTC advertising. According to Dr. Sweet, ACP members say that more patients are giving them lists of drugs they want to try, many of which are not appropriate.

Physicians must then spend time explaining why other medications might be more beneficial. "When a physician withholds something a patient wants, patients often mistrust the physician," Dr. Sweet told senators. "The result is a subtle but chronic adversarial element in the doctor-patient relationship."

The testimony is online.

ACP supports amendments on prisoner rights

The College has voiced support of amendments recently added to a federal defense authorization bill that prohibit cruel, inhumane or degrading treatment to prisoners in U.S. custody.

In a Sept. 21 letter to Sen. John McCain (R-Ariz.), the amendments' author, the College said ACP agrees with establishing and maintaining clear policies to prevent prisoner and detainee abuse.

The letter pointed out that both the College's "Ethics Manual, Fifth Edition" and a 1995 position paper require physicians to speak out against torture and to condemn interrogation techniques that inflict physical or psychological harm.

The letter noted that Sen. McCain's amendments restrict interrogation to authorized techniques and affirm U.S. commitment to human rights and humane prisoner treatment. The letter is online.

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