Letter to UHCNE Senior Medical Director
August 10, 1999
Anthony J. Kazlauskas, MD
Senior Medical Director
United HealthCare-New England
475 Kilvert Street
Warwick, RI 02886-1392
Dear Dr. Kazlauskas:
On behalf of over 115,000 physician-members of the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), I am writing to United HealthCare-New England to terminate the planned launch of a mandatory hospitalist program for Medicare beneficiaries.
A mandatory hospitalist program will fracture the continuity of patient care. Furthermore, denying patients the right to choose their personal physician to care for them at the time when they are in need of hospital care will decrease satisfaction among patients and provoke outrage from physicians. ACP-ASIM's official policy is to support hospitalist programs only if participation is voluntary. Patients must have the opportunity to discuss the potential advantages and disadvantages of hospitalist programs with their primary care physicians and must be free to choose. In addition, we note that the National Association of Inpatient Physicians (NAIP), the organization that represents hospitalists nationwide, also opposes mandatory hospitalist programs.
Managed care organizations should be learning a lesson from their recent experiences. Some years back, managed care organizations offered patients a limited choice of network physicians, only to learn that they had neglected patients' expressed wish to choose their physician. I believe that you will get the same message if you persist in your current misguided effort to limit freedom of choice for patients. When patients start to realize that United HealthCare will prevent them from receiving care from their regular physician when they require admission to the hospital, you will see a backlash. In this situation, you have pushed too hard to restructure health care at the expense of patients' interests, and I think you will pay a price.
Although managed care has served the public interest in some ways, some health plans seem to feel that they can do anything to the profession of medicine in the interests of cutting costs. What you are doing, in this instance is to attempt to restructure health care to meet your corporate needs. We urge United HealthCare to reconsider before everyone, including yourselves, suffers harm. Don't impose a mandatory hospitalist program.
Sincerely,
Alan R. Nelson, MD, FACP
Associate Executive Vice President
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