Minnesota Physician-Patient Alliance, Inc. ("MPPA") is a not-for-profit organization committed to improving our health care system. We do this by communicating information to the public and within the industry about important health care issues.
MPPA believes that efficient, quality health care depends on strong doctor-patient relationships. Interference in the doctor-patient relationship by third parties such as health plans and the government, is widespread in today's health care system and often limits what doctors or patients are allowed to do, altering market-based reimbursement, and undermining the traditional ethics of the medical professions. While the intentions of the third parties in interfering with the relationship may be honorable (for example, to control costs or improve quality), ironically the cumulative effect of this interference is unnecessarily high costs and reduced quality. Efforts to reform health care, therefore, must first and foremost address the issue of strong doctor-patient relationships.
The MPPA board consists of physicians, health care consumers, and others who share these concerns and values. We seek to communicate our message by collaborating on research and publication, sharing information about market developments, and individually being active in a variety of health care and community organizations.
To see who belongs to MPPA, please visit our Who We Are page by clicking on the link to the left. To see some of our communications, click on the Publications link to the left. If you would like to learn more about MPPA or our positions, click on the Contact Us link to the left.
MPPA is tax exempt 501(c)3 corporation organized in the state of Minnesota.
January 10th, 2011
Financial considerations are always part of the health care equation. Would I be better off having a check-up every month instead of every year? What are the cost and benefit considerations for me? Doctors need to collaborate with and educate patients. There are what — 90 some diagnostic tests that can be done on my blood sample. Why shouldn’t I have all 90 done every time I go to the doctor? To optimize my health, should I as a patient have or buy insurance that pays for 100 percent of everything I think I need? or, even everything my doctor thinks I need?
My point is that irrespective of the degree of freedom in the health care system, there will always be rationing by cost and affordability. The key question is: who decides what will be rationed — me and my doctor or someone else? When I ration my own health care (with my doctor’s recommendations), finances are for me a big part of the equation, and they should be. Otherwise, with me considering costs there is no “rationing mechanism,” and consequently no consistent way to reliably allocate medical resources to what is best for patients.
January 10th, 2011
MPPA believes that “doctors recommend and patients (or parents) decide” on their personal health care. Even when patients are civilly commitment or legally incompetent they continue have legal protections which respect their autonomy. Physicians and clinics should post (online) and routinely discuss the costs of health care that is recommended to their patients. Money issues and care costs should be part of (non-emergency) doctor-patient discussions and care plans.
A Hippocratic (person-centered) physician ethic is a necessary patient protection. MPPA believes this traditional ethic is necessary for physicians rather than tasking physicians to be (Platonic) gatekeepers of public (taxpayer) or insurance dollars. The Moreover, the person-centered Hippocratic ethic not only does not conflict with sound public health practices it enhances it. In our diverse society, It is essential that Individual patients and their families (or designated decision-makers) can “decide” their personal health care choices based on their personal and cultural preferences.
MPPA believes that the only payment or reward a clinical doctor can rightly expect is money for his professional services to patients, either in the form of fees-for-service or salary.
Physicians and clinics should both post and discuss the costs of health care they recommend to patients. Unless on the gurney or en route to the ER, money issues and costs should be part of the language of doctor-patient discussions.
Doctor-patient alliance and trust is violated when a physician exploits a patient in self-serving ways. In addition to blatant “no-no” behaviors of intimidation, sex with patients, and stealing, a conflict of interest is present when a doctor assumes a “gatekeeper” function for health care resources potentially available to or withheld, and when s/he receives payments or enhanced salary for promoting or excluding pharmaceutical prescriptions or medical devices not only based on what is best for the patient.
Also, things get dicey ethically when doctors make money by not caring for patients or splitting health care money with other parties — including insurance companies or other providers– rationalizing this behavior as apportioning scare resources and deciding what is best for a population of patients. A physician’s professional training and ongoing education are geared to learning what is likely to help and harm individual patients, and also what are good public health practices.
Since money really matters in the doctor-patient transaction, and this is crucial, protection for both patients and doctors best occurs when patients have actual power to direct money for their health care. Also, patients need to have choices of third party health care insurance that they can keep, regardless of current employment or government economic assistance status. And, MPPA strongly advocates patient access to all contracts and with insurance plan enrollees.
Lee Beecher, MD