New problems in the scope-of-practice controversy [Ear, Nose & Throat Journal]
By Sataloff, Robert T | |
Proquest LLC |
Patient safety and quality of care are primary concerns for physicians and all responsible allied health professionals. However, disagreements between otolaryngology and other health organizations (such as the
In general, the discussions and debates have been vigorous but civil, and relationships between most otolaryngologists and most speech pathologists remain good, as do relations between our professional organizations for the most part, despite some disagreements over scope of practice.
A recent related development has introduced a potential patient risk about which physicians and audiologists are united in steadfast agreement. In many jurisdictions, hearing aids cannot be sold without a purchaser either having a medical evaluation and hearing health diagnosis, or signing a waiver declining medical consultation. This process was intended to protect the general public from inappropriate hearing aid sales and to prevent delayed diagnosis of serious conditions. Recently, however, the process has been undermined and bypassed by
By revenue, UHC is the largest health insurer in
Most reputable hearing aid manufacturers have a public policy against the sale of their hearing aids online. Therefore, the HHI model is in conflict with the standard of practice within the hearing aid industry. This is no small issue. Even if this policy involved only UHG/UHC's clients and not the general public, the impact would be substantial. UHG/UHC clearly has established an aggressive strategy targeting the elderly population. Also on
On
At present» it is not clear whether UHG/UHC will be liable for missed or incorrect diagnoses or whether, in its role as an insurance company, it will have legislative immunity (under the Employee Retirement Income Security Act [ERISA]). One might argue that such protection would not be appropriate since the insurance company is clearly venturing into the practice of medicine with this initiative. However, one might make the same argument about insurance company "medical directors" who determine what studies and operations our patients may or may not have (the practice of medicine, it seems to me); and yet the insurance companies generally enjoy protection from the consequences of their actions, when similar actions by individual practitioners could result in malpractice suits.
This new approach by UHG/UHC is a matter for serious investigation in and of itself, but if it is allowed to stand and marks the beginning of a new trend in the delivery of hearing health and/or geriatric care, it is even more disturbing. Otolaryngologists should follow this matter closely and be alert to help patients who have been treated suboptimally through the HHI process.
Reference
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Editor-in-Chief
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Copyright: | (c) 2012 Medquest Communications Inc. |
Wordcount: | 743 |
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