Joint Principles for Protecting the Patient-Physician Relationship

Washington, DC (May 23, 2018) — Today, the American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG) and American College of Physicians (ACP) issued a set of Joint Principles Protecting the Patient-Physician Relationship: Keeping External Interference Out of the Practice of Medicine.

Our organizations, which represent more than 400,000 physicians and medical students, call on policymakers to join us in preserving the patient-physician relationship by ensuring that the practice of medicine is not unduly impeded by government interference. A growing number of policy proposals aim to interfere in the practice of medicine and threaten access to evidence-based care.

Critical to achieving this goal is respect for the importance of scientific evidence, patient autonomy and the patient-physician relationship. Our organizations have adopted these principles, which are designed to ensure our patients have continued access to coverage and medically accurate, evidence-based care.

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Protecting the Patient-Physician Relationship: Keeping External Interference Out of the Practice of Medicine

Joint principles of the following organizations representing front-line physicians:

American Academy of Family Physicians
American Academy of Pediatrics
American College of Obstetricians and Gynecologists
American College of Physicians

On behalf of the more than 400,000 physicians and medical students represented by the combined memberships of the above organizations, we adopt the following principles related to protecting the patient-physician relationship, in response to the growing number of policy proposals that inappropriately interfere in the practice of medicine and threaten access to evidence-based care.

Our members are the front-line physicians who care for patients in rural, urban, wealthy and low-income communities, and are the foundation of the American health care system. In recent years, we have seen increasing political intrusion into the patient-physician relationship. This interference limits patient access to medically accurate information and availability of the full range of health care options.

We call on policymakers to join us in putting patients first. Critical to achieving this goal is respect for the importance of scientific evidence, patient autonomy, and the patient-physician relationship. Our organizations adopt the following principles, to ensure our patients’ access to evidence-based coverage and care and that none of our patients lose the coverage they have today.

  1. Support participation of any qualified provider in federally and state-funded programs. Medicaid’s federal “any willing provider” and “freedom of choice” protections are enshrined in law to ensure that an adequate number of providers participate in the Medicaid program to care for Medicaid beneficiaries. Evidence has demonstrated that restricting participation of qualified providers results in loss of access to critical care for our most vulnerable patients.[i],[ii]
  2. Maintain coverage of evidence-based essential health benefits, such as maternity coverage and women’s preventive services without cost-sharing, including contraception. Preserving access to this existing coverage is critical to ensuring American women and families can access the care that they need. Over 8.7 million women gained maternity care services thanks to this coverage, and 62 million women with private insurance now have access to vital preventive services.[iii],[iv]
  3. Ensure evidence-based federal programs, including Title X and the Teen Pregnancy Prevention Program (TPPP), receive continued federal funding and preserve evidence-based program requirements. Title X is the only federal program exclusively dedicated to providing low-income and adolescent patients with essential family planning and preventive health services and information. Evidence-based sexuality education programs help young women achieve their educational and professional goals by educating them about sexual health, including preventing unintended pregnancy and family planning. These and other federal programs must continue to provide non-directive, comprehensive, medically accurate information.
  4. Reject government restrictions on the information our patients can receive from their doctors.  Patients expect medically accurate, comprehensive information from their physicians; this dialogue is critical to ensuring the integrity of the patient-physician relationship. No governmental body should interfere in our members’ obligation to provide evidence-based information to their patients. When our government restricts the information that can be given to women, or forces physicians to provide women with non-medically inaccurate information, we can expect increased rates of unplanned pregnancy, pregnancy complications, and undiagnosed medical conditions.

Our organizations reject political interference in the patient-physician relationship, and welcome policymakers to partner with us to advance the health of our nation.

About the American Academy of Family Physicians
Founded in 1947, the American Academy of Family Physicians represents 131,400 physicians and medical students nationwide, and it is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five of the total medical office visits in the United States per year – more than any other specialty. Family physicians provide comprehensive, evidence-based, and cost-effective care dedicated to improving the health of patients, families and communities. Family medicine’s cornerstone is an ongoing and personal patient-physician relationship where the family physician serves as the hub of each patient’s integrated care team. More Americans depend on family physicians than on any other medical specialty.

To learn more about the AAFP and family medicine, visit
www.aafp.org/media. Follow us on Twitter, and like us on Facebook. For information about health care, health conditions and wellness, visit the AAFP’s award-winning consumer website, www.familydoctor.org.


About the American Academy of Pediatrics
The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds.

About the American College of Obstetricians and Gynecologists
The American College of Obstetricians and Gynecologists (ACOG) is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, ACOG strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. www.acog.org

About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 152,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.


 [i]Stevenson AJ, Flores-Vazquez IM, Allgeyer RL, Schenkkan P, Potter JE, Effect of removal of Planned Parenthood from the Texas Women's Health Program., N Engl J Med, 2016, vol. 374 (pg. 853-60).

 [ii] Peters PJ, Pontones P, Hoover KW, Patel MR, Galang RR, Shields J, et al, Indiana HIV Outbreak Investigation Team. HIV infection linked to injection use of oxymorphone in Indiana, 2014-2015., N Engl J Med, 2016, vol. 375 (pg. 229-39).

 [iii] Garrett, D. National Women’s Law Center, Turning to Fairness: Insurance Discrimination Against Women Today and the Affordable Care Act (Mar. 2012). Available at http://www.nwlc.org/sites/default/files/pdfs/nwlc_2012_turningtofairness_report.pdf

 [iv] National Women’s Law Center. New Data Estimates 62.4 Million Women Have Coverage of Birth Control Without Out-of-Pocket Costs. September 2017. Available at https://nwlc-ciw49tixgw5lbab.stackpathdns.com/wp-content/uploads/2017/09/New-Preventive-Services-Estimates-3.pdf.