Legislating Medicine State by State


Separate similar bills have passed the Massachusetts House and Senate; a joint committee is now working out the differences.

The Massachusetts Medical Society hasn’t endorsed either of the plans, but urged lawmakers to take a "market-led" approach, avoid unnecessary bureaucracy in setting these new requirements and to provide additional support for the transition to EHRs.

One bright spot in the bills is the inclusion of a disclosure, apology, and offer provision that sets a 182-day cooling off period after the filing of malpractice claim. The disclosure, apology, and offer policy would allow for an open, transparent discussion and the ability to provide compensation to patients when appropriate, according to Dr. Richard V. Aghababian, president of the Massachusetts Medical Society.

Abortion Politics

In just the first 3 months of this year, lawmakers around the country introduced more than 900 provisions related to reproductive health; about half were restrictions on abortion, according to an analysis from the Guttmacher Institute.

Among the trends noted by the Guttmacher analysts is a move to require an ultrasound before abortion and restrictions on non-surgical abortions.

Kathryn Moore, director of state government affairs at the American College of Obstetricians and Gynecologists, said that in the last year or so, she’s seen a "more aggressive effort" to legislate reproductive health issues than she’s seen in several years.

The Virginia legislation that got a lot of attention requires women to have an ultrasound at least 24 hours before they can obtain an abortion. Women will be offered the chance to view the ultrasound image but can refuse. Physicians who fail to comply with the law could face a $2,500 fine.

Gov. Bob McDonnell (R) signed the law in March; it goes into effect this summer.

Dr. Sandra B. Reed

State lawmakers revised the law’s original language, which would have required a transvaginal ultrasound.

Earlier this year in Georgia, the legislature passed a bill criminalizing abortion after 20 weeks from fertilization. The new law is problematic because it limits the ability of ob.gyns. to identify pregnancies in which a fetus is going to be nonviable but could carry to term, said Dr. Sandra B. Reed, and ob.gyn. and president of the Medical Association of Georgia.

"I don’t like it," Dr. Reed said. "They are legislating medical care and they didn’t go to medical school. They don’t understand all of the ramifications of what they are doing in a day-to-day practice."

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