Whose Law Is it, Anyway?

Should Congress stop physicians from providing handwritten scripts to pharmacies?

Yes, say several members of the U.S. House and Senate. They believe that electronic prescribing, or e-Rx, could reduce medical and administrative errors and improve patient safety, and they're pushing for a law to require physicians to do away with their pads and pens and adopt an electronic prescription system by 2008.

But most physicians who responded to the Physicians Practice 2004 Political Survey -- 65 percent -- said they would oppose such a federal law.

Proponents for e-Rx have plenty of numbers to support their arguments -- for one, the landmark 1999 report by the Institute of Medicine (IOM), which estimated that medication errors in hospitals were to blame for at least 44,000 deaths every year. And there's the Institute for Safe Medication Practices, which claims that hard-to-read prescriptions prompt 150 million telephone calls a year from pharmacists to physicians.

Even more troublesome are the calls that don't happen. In Texas, a cardiologist prescribed 20 mg of Isordil for angina; a pharmacist misread the directions and dispensed 20 mg of Plendil, twice the suggested dose. The patient took the drug, had a heart attack, and died, according to the AMA. A lawsuit resulted in a $450,000 judgment against both the pharmacist and physician.

If the public sees the debate on e-Rx as black and white -- will it save patients' lives or not? -- you can guess the end result. But an unfunded, untested federal mandate on e-Rx is unfair to physicians. If better patient care is the reason for e-RX, then once a viable system is in place, the full costs should be paid by the public directly.

The American College of Physicians, among other groups, is working to that end, urging a national study on e-Rx before it is adopted nationwide with physicians voluntarily participating. Others are calling for federal grants to physicians who begin to use e-Rx.

Physicians voices' need to be heard on this issue.

And hearing your voices is why we launched this first annual Physicians Practice Political Survey. We will share the results with members of Congress, the Bush administration, and the media.

Physicians Practice 2004 Political Survey Results

• Support medical malpractice caps 94%
• Support increases in Medicare payments to physicians  93
• Oppose expanded CPT systems 67%
• Oppose mandated electronic prescriptions  65%
• Support President Bush's re-election 50%
• Those who do not support Bush favor:
  Dean   58%   Clark   13%  All others   1% each

Are physicians in your community challenging the assault on the practice of medicine? E-mail me details at kkarpay@physicianspractice.com. And to join other physicians who want to see the political system changed to better support physicians' practices and patients' health, subscribe to my free e-mail newsletter. Send me an e-mail at kkarpay@physicianspractice.com with "Subscribe" in the subject line.

This article originally appeared in the February 2004 issue of Physicians Practice.