November 15, 2012

Today's Doctors Are Without a Moral Code

Normally I do not write about women's health or gestational diabetes. This is one time I feel I must as the doctors are showing their true colors and arguing against making changes to the guidelines for gestational diabetes. If they were supporting changes, then I would not be writing this. However, this time I think they have abandoned the Hippocratic Oath in favor of profits and this does not seem the proper thing for doctors to come out in favor of doing.

At issue is some in obstetrics and gynecology and maternal-fetal medicine have advocated for change to the diagnostic criteria for gestational diabetes for some time now, while others, including the American College of Obstetricians and Gynecologists, say it is not clear that change is needed. Some information is needed here. Under the Affordable Care Act (ACA), money will be available for doctors to reduce medical costs at all levels of medical care. This is what doctors are afraid of losing if new guidelines are put in place tightening the diagnosis and treatment of gestational diabetes.

The upcoming Consensus Development Conference in early 2013 is to assess available scientific evidence for gestational diabetes. In advance of this conference, the opposition is writing articles in opposition to possible changes. The authors advised that "such a change would dramatically increase the number of women identified as having this disease and place a significantly greater burden on an already overburdened primary health care system. We have concluded that before change is made, there needs to be careful analysis of the possible risk, cost and benefit involved in any revisions. If the data aren't available to answer these questions, it would seem prudent and advisable to delay change at this time."

Follow the dollar signs is all I can derive from the discussion. Normally doctors look to the health of the patients (mother and unborn child in this case) and forget about the cost-benefit analysis in favor of health. This time the medical community is placing the emphasis on the cost-benefit analysis instead to the health issues. “Gestational diabetes is a condition that can be potentially devastating to pregnancies. Even mild forms of hyperglycemia could potentially pose significant adverse health consequences for pregnant women and their children. Advocates for changing diagnostic criteria - increasing the number of women diagnosed with and thus treated for the condition - could reduce morbidity and health care costs. Those cost reductions, however, could be offset by an increase in patients diagnosed and treated.”

Each side is bringing in the big guns to bolster their arguments and they are quoting study after study on both sides of the issue. For those on the “do not change” side, I feel they have lost their moral compass and are only interested in the dollars they can divert to their pockets. I can only suggest that you read the article and decide for yourself, which side of the issue you favor. The second article is here.

This just came to my attention - Tom Ross has an excellent blog on the same topic.  Read it here.

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