Doctors' group faults referral bill STATE HOUSE

February 25, 1993|By Tom Bowman | Tom Bowman,Staff Writer

The state medical society yesterday came out against a bill that would prohibit doctors from referring patients to clinics or laboratories in which they have a financial interest.

The measure, which last year passed the House but died in a Senate committee, would end what the bill's proponents say is a growing problem that is adding to the cost of health care.

But representatives of the Medical and Chirurgical Faculty of Maryland, the state medical society, argued that the problem may not exist. And they said the society should police its members, not the state.

Del. Ronald A. Guns, chairman of the Environmental Matters Committee and sponsor of the bill that was heard by the committee yesterday, stressed that the problem is real.

"The evidence is overwhelming that these referral relationships result in abuse, overcharging and over-utilization," the Cecil County Democrat said. "By enacting a comprehensive, across-the-board ban on referrals, we can protect and improve consumers' confidence in their health care providers."

Del. Lawrence A. LaMotte, D-Baltimore County, said there is "irrefutable evidence" that such referrals are driving up health care costs.

Supporters pointed to several studies, including one involving Maryland. In 1989, the General Accounting Office, the watchdog arm of Congress, found that doctors with an interest in a lab tended to order a greater number and more expensive tests than physicians who were not investors.

At the same time, Mr. Guns and other advocates pointed to a policy adopted in December by the American Medical Association stating that doctors in general should not refer patients to a health care facility in which they have a financial interest.

Currently, several states, including Florida, New York and Illinois, bar such referrals. In Maryland, about 18 percent of clinical labs are owned by physician investors who do not work in the lab.

Officials of the medical society said the group agrees with the AMA policy statement and is convening a committee on self-referral that would render opinions and adjudicate specific situations.

"We are dedicated to cleaning out that problem if it exists," said Marvin Mandel, the former Maryland governor who is now one of the society's lobbyists.

"We think we can do it better than the state," said Dr. Paul A. Stagg, chairman of the society's self-referral committee.

Dr. Carol Garvey, another society member, said the group is concerned about creating new bureaucracy, noting that legislation also is pending in Congress that would bar self-referral.

"Our real concern is that we're just loading on the bureaucracy," she said, a move which would add to the cost of medical care.

Delegate LaMotte noted that last year representatives from the doctors' group had testified on behalf of a similar bill.

But Mr. Mandel denied that the society was reversing its stand, contending that the society last year was taking a stand on principle and not on a specific bill.

Mr. LaMotte suggested that politics within the society -- which has new leadership -- were responsible for the change in position.

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