The D.C. Medical Society has warned that more competition for doctors at Washington hospitals could be hazardous to your health.
The society launched a major lobbying campaign over the weekend against proposed legislation before the D.C. City Council that would encourage granting of hospital privileges to qualified nurse midwives, psychologists, podiatrists and other nonphysician health professionals. The measure has been endorsed by a majority of members of the council.
Council member Polly Shackleton (D-Ward 3), chairman of the human services committee, said in introducing the bill that it would "encourage less costly, alternative forms of health-care delivery" and would enhance competition in the health-care field.
But the medical society envisioned erosion of standards, speculating in its newsletter that "pretty soon a boy scout with a rusty knife will be permitted to perform brain surgery."
In addition, only "insolvent or irresponsible" persons would be willing to serve on hospital governing boards that determine who will have hospital privileges, a separate position paper asserted.
This, it said, would be because more competent, talented persons would not serve if the bill is approved because the measure would increase the chance that members of governing boards could be held personally liable for rejecting some nonphysician applicants.
The position paper also predicted costs would increase--rather than moderate--because people will demand more health services if there are more health providers available.
"Clearly, we have all observed that in commercial marketing of products, the phenomenon of competition tends to drive down price and unit cost," the paper declared.
"However, what seems to have been forgotten is the fact that effective competition depends upon increased supply interacting with static demand," not patients seeking more services.
Furthermore, a provision in the proposed legislation to make public reports and recommendations dealing with the quality of care at individual hospitals would "not serve the public interest," the society position paper states.
Members of the society plan to meet today with City Council members to discuss the bill, and have sent out an unusual "legislative alert" to some 2,500 city doctors asking them to contact council members to voice opposition to the measure. The bill is sponsored by a majority of the council, including Chairman David A. Clarke.
The proposed legislation would forbid discrimination against psychologists, podiatrists, nurse practitioners, nurse midwives and nurse anesthetists as a class.
The legislation also would change licensing procedures, require inspections of more health-care facilities, including hospices, birthing centers and home-care agencies that would be inspected and licensed for the first time.
"I count many nonphysician health professionals as good friends and professional colleagues," said Dr. Dennis S. O'Leary, president of the medical society, in the group's May newsletter, "and most of these individuals provide excellent service within the scope of their education and training."