subject: The Truth On The Hippocratic Oath [print this page] The shock of an associate professor from a prestigious medical university came as he learned that he will be let go from the provider system of a US health services company. The largest HMO on the east coast gave no reason for the firing, but the doctor thought this has something to do with his public criticisms about HMOs. He was constantly criticizing the fact that these HMOs, along with others who only go for profit and undermines the care the patients badly need by even rewarding physicians who decline the needed care and also by making them sign gag clauses stipulated in every standard contract by this HMO.
Under this contract, the doctor must agree to never taking any form of communication or action that will dishearten enrollees, potential enrollees, their superiors, union members or the quality of the coverage and most importantly, all these are to be kept confidential. To make it short, a physician who slips on saying things to his patient that the HMO won't agree with can cost him his job.
In the present medical situation, where profit is the bottom line, these policies implemented by HMOs prevent doctors from giving the real score on patient's diagnoses, prognoses and other options for cure. Since these doctors are kept silent, just think of these possible situations that could become real.
A 49-year-old lady sees a vague shadow in her mammogram results. Her doctor thought of undergoing another test to make sure that the troublesome result was just a machine error and not a cancer. The bad news is that this is not covered by the HMO. The quality of care the HMO gives to its patients could be criticized by recommending a second mammogram for themselves. after six months, the doctor recommended the patient to be back for another check-up enable to lessen the findings. Sad to say, but she could have difficulties in that six months if she really has cancer of the breast.
to lessen the obstruction brought by the enlarged prostate, a 60-year-old man needs an operation. The surgeon is contemplating on availing the latest laser operation technique that inhibits blood loss, impotence, pain and lowers the risk of infection. But the truth is that the patient's HMO will only be used for a more invasive operation with a lot of risks. The surgeon could be fired if he insists to his patient to undergo the new surgery and persuade in order to ask permission from the HMO.
A 35-year-old woman is currently facing sever bouts of depression. Her physician intended to make her take a form of medicine that has very little side effects and zero death chances on a careless overdose. However, the HMO has agreed to push for the drug that has so many side effects as well as the chance of death from overdose. Purchasing the better brand by herself is suggested by the doctor. But sadly, he signed a contract that won't allow him to say a word. Patients who are well-informed has the capacity in making a better health care decisions.
Although the rapid advancements in medical knowledge is available, many consumers, even the smartest ones still depend on their doctors due to its complexity. Health care fates of the patients could fail if the physicians will not be honest with their patients. In a place like this, it is foolish for patients to think that their doctors are telling them the entire truth.
It is good to know that nurses associations and consumer watchdog groups based in California have filed an initiative that will put a stop to these gag orders. HMO patients can now consult their physicians through their professional associations, legislation and public education. The courageous example of this doctor who got fired from the company because of his criticisms against their policy should be followed by other people. Upon receiving his contract from the HMO, he opted to send it back after crossing out the gag clause.
The medical field swears by the Hippocratic Oath which maintains that doctors should care for their patients to the greatest of their powers and judgment and never cause anyone harm, and yet the contracts of HMOs which contain gag orders contradict this oath. How can doctors who have sworn to uphold that oath take another pledge that puts his patients at such risk?
