Therapy not the answer


By Jimelle Rumberg, Ph.D, CAE Executive Director - Ohio Foot and Ankle Medical Association



Editor:

More than 660 licensed and resident podiatric physicians and surgeons belong to the Ohio Foot and Ankle Medical Association. Our members literally keep Ohioans on their feet. We’re committed to that mission, so when we see an opportunity to speak up for patient safety, we take it.

State Senators Peggy Lehner (R-Kettering) and Charleta Tavares (D-Columbus), introduced House Bill 243 to limit “step therapy.” That sounds like something of special interest to foot and ankle doctors, but in fact it’s the way health insurers second-guess all types of physicians by refusing to pay for medications they’ve prescribed. As an alternative, the insurer makes patients go through a number of “steps” trying cheaper medications instead of the one the physician has prescribed. Therefore, only if these other medications fail will the insurer allow the original prescription. That’s not good business or good medicine. Patient care should not be dictated by the whims of an insurance company trying to save a dollar.

Our surgeons encounter this practice frequently. Many surgical patients, including amputees, need prescription pain medication over an extended period. Their doctors work closely with them to manage their pain and speed their rehabilitation. However, we often find insurers who want to transition the patient to an over-the-counter pain reliever much too quickly. That can slow recovery and cause unnecessary suffering. These decisions should be made exclusively by the doctor in consultation with the patient, not by an insurance underwriter.

We understand the need for cost containment in the healthcare industry, but step therapy is not the way to achieve it.

Signed,

Jimelle Rumberg, Ph.D, CAE Executive Director

Ohio Foot and Ankle Medical Association

By Jimelle Rumberg, Ph.D, CAE Executive Director

Ohio Foot and Ankle Medical Association