AMA physicians want more input with JCAHO

Delegates to the American Medical Association's (AMA) House of Delegates criticized the JCAHO for not heeding the input of physicians in adopting new standards, and sounded the alarm on standards they view as undermining physician autonomy, at the group's policymaking meeting in Las Vegas in November.

The JCAHO should notify physician groups six months in advance of adopting or modifying new standards, the delegates determined, and make the standards available to any licensed physician in print or online format "without hindrance," according to a report in the Dec. 4 edition of American Medical News, a publication of the AMA.

The delegates passed resolutions on key standards, MM.4.10 (medication reconciliation), and MS.1.20 (medical staff governance).

On MM.4.10, which requires that prescriptions for non-urgent or high-risk drugs to be reviewed by a pharmacist prior to giving the first dose to the patient, delegates called for changing the standard, "so that medication administered in a hospital setting does not require first-dose review by a pharmacist."

Responding to MS.1.20, which allows medical executive committees to act on behalf of the medical staff to propose medical staff bylaws directly to the governing body, the AMA delegates proposed including language to the standard that recognizes the self-governing nature of medical staffs, and the rights of medical staffs to develop policies, to assess dues, and retain legal counsel.

"JCAHO is being used as a tool by the government to take over the practice of medicine through the hospitals," said David McKalip, MD, an alternate delegate from Florida, according to the article. "We are working in medical staffs to take back control of medicine in our hands, and we are losing."

Source: "Doctors demand more input on hospital standards," American Medical News, Dec. 4, 2006.