American College of Physicians: Internal Medicine — Doctors for Adults ®

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Policy Briefs

From the November ACP Observer, copyright 2004 by the American College of Physicians.

White House responds to ACP's prison abuse concerns

The Bush administration has responded to issues raised by the College about alleged abuse of prisoners held under U.S. control in Iraq, Afghanistan and Guantanomo Bay.

In an Oct.12 letter signed by a special assistant to the president, the administration said it condemns the abuses at Iraq's Abu Ghraib prison as "horrific and wrong." The letter further states that, consistent with College requests for an investigation into U.S. interrogation practices, the administration has ordered a complete accounting of abuse allegations, with investigations now underway to improve detention operations. In interrogating prisoners, the letter says, American personnel "will not compromise the rule of law."

Over the past year, ACP has sent two letters to the administration with concerns about alleged mistreatment of prisoners. The letters were prompted by long-standing College ethical policy requiring physicians to speak out against torture.

The full text of the White House's response is online.

The College's letters to the administration are online.

ACP calls on Senate to support full Title VII funding

The College has joined with other groups representing primary care physicians to urge Senate and House leaders to support full Title VII funding for 2005. Title VII funding is the only federal support given to help train the primary care workforce.

In an Oct. 5 letter, the College, along with 10 other medical organizations, called on Congress to support the full $90.7 million for Title VII funding currently contained in a bill before the Senate. Any Title VII funding decrease for 2005 would devastate general internal medicine and pediatrics training programs, the letter stated, particularly in the wake of a 12% Title VII funding decrease in 2004.

As many as 50% of those trained in Title VII programs go on to work in underserved areas, compared to only 10% of those in other training programs, the letter noted. Title VII programs also increase the diversity of the physician workforce and train up to five times as many minority and disadvantaged students than programs without such support. The letter is online.

College urges House leaders to enact patient safety bill

The College is asking leaders of the House of Representatives to move this month to enact a bill that would establish a patient safety reporting system that would have confidentialty protections.

In a Sept. 20 letter, ACP joined more than 100 other medical and health care organizations in urging quick passage of the Patient Safety and Quality Improvement Act (H.R. 663). A Senate version of the bill passed in July, while the House passed a previous version in March 2003. The two bills must now be reconciled and a final version passed by both the House and the Senate before it can be signed into law.

If passed, the bill would establish patient safety organizations that would collect safety data submitted by health care providers.

Those data would then be analyzed to help devise strategies for preventing similar errors. The measure would also include privacy protections and provide for civil fines for privacy violations. The bill would also contain several confidentialty protections for both individuals and institutions reporting errors.

The letter was sent to the chair and the ranking member of the House Committee on Energy and Commerce. The letter is online.

ACP urges USP to draft less restrictive drug lists

In comments sent to the U.S. Pharmacopeia (USP), ACP called on the standards-setting organization to expand the drug classification list contained in its draft model guidelines.

The USP guidelines are designed to help develop drug categories and classes that will be used by prescription drug plans. Those plans will offer prescription coverage to Medicare beneficiaries under the Medi care drug benefit slated to take effect in 2006.

In a Sept. 17 letter, the College told USP that its proposed list would eliminate numerous therapeutic agents from coverage, including statins, glitazones and selective serotonin reuptake inhibitors.

The College also asked the USP to revise its guidelines to correct other deficiencies. Recommendations included dividing the USP's pharmacologic class of opioid analgesics into long- and short-acting agents and including a pharmacologic class for ondansetron hydrochloride in the antiemetic therapeutic category.

The College pointed out that expanding the list would not be a detriment to controlling costs. The College also asked the USP to clarify how drugs with off-label and multiple uses will be treated in the model guidelines. The letter is online.

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