A delicate compromise between the medical society and state regulators has collapsed, with the board of the doctor group rejecting modifications in the state's data collection program.
Earlier this month, the Health Care Access and Cost Commission approved additional confidentiality protections on the data it collects, largely following a proposal from the medical society, the Medical and Chirurgical Faculty of Maryland, or Med-Chi.
But the medical society's board rejected the compromise Thursday night. That leaves Med-Chi where it was before the attempt to reach an agreement -- favoring legislation that would prohibit collecting data without the consent of the patient.
The commission gets information about doctor visits from insurance companies so it can study what care is given in Maryland and how much it costs. It says patient confidentiality is protected through a number of measures, such as using code numbers rather than patient names. But a group of civil libertarians and doctors has been battling the database, saying the information could be misused and privacy breached.
The vote by the medical society's board came on the heels of another controversy over state agencies collecting medical data. The Board of Physician Quality Assurance, which monitors doctor conduct, proposed putting doctor discipline and malpractice records online for consumers, drawing a swift protest from the medical society.
That dispute "certainly didn't help the discussions any" as the Med-Chi board considered the latest HCACC action, said Dr. Alex Azar, president of the medical society. "It made doctors very fearful and distrustful of state regulators. It's a very visceral subject." A member of HCACC as well as president of the medical society, Azar had worked to forge a compromise.
John M. Colmers, executive director of HCACC, said, "The most important point is that all the legitimate concerns addressed by Med-Chi were addressed, and addressed fairly. To have the rug slipped out beneath us is really unfortunate." HCACC had agreed to additional privacy protections, including coding doctor as well as patient names, at a meeting this month.
"We continue to believe that informed consent in the case of data anonymously collected is not necessary," Colmers said.
But T. Michael Preston, acting executive director of the medical society, said he thought chances were good of getting an informed-consent requirement passed by the legislature in 1997 because it is a simple concept for the public to understand. "Compromise is complicated," he said, "and consent is not."
The society had supported consent legislation in the 1996 session, but, had its board agreed to the compromise with HCACC, would not have done so in 1997.
Mimi Azrael, a member of the coalition supporting consent legislation representing the American Civil Liberties Union, the Women's Law Center of Maryland and the Family Law Center, said, "The consent coalition welcomes Med-Chi's return."
Pub Date: 12/21/96