GUEST COLUMN: Physicians and patients — not bureaucrats — know best

Published: Thursday, February 6, 2014 at 04:50 AM.

Access restrictions can prohibit a provider from prescribing what they believe is the best therapy option for a patient. For example, these patients need to know there is a clear and convenient process to quickly request and override any step therapy or fail-first protocol if a doctor determines that a drug on the standard managed care protocol will not work, or could even worsen a patient’s condition.

A physician should not have to wade through bureaucratic red tape to have the more appropriate treatment covered by an insurance company. 

Instead, there should be a clear and convenient process to request an override when it is medically necessary for a patient to have an alternative, more appropriate, treatment. 

My physician has been treating me for 10 years. She knows what my diagnoses are, and how to best treat and cure those illnesses that can be cured. To have her excellent care disrupted by health insurance policy, with no provision for emergency backup, is unconscionable and unacceptable. Health insurance companies need to apply the same policies and procedures across the board. It should not be a matter of each company deciding to manipulate medical information to further their own profit. 

Individuals should be responsible for their own health. And these patients should be able to work with their physicians to determine the best course of medication, rather than having bureaucrats make the final decisions on the most appropriate treatment options.

We support the Florida Legislature’s efforts to strengthen and improve vital patient access.

Edith Gendron is the diabetes patient and Brain Bank Program manager at the Central Florida Brain Bank, Alzheimer’s and Dementia Resource Center.



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