Doctors failing pregnant patients

Here's another glowing review of American health care. This time, docs fail to warn pregnant patients of the dangers of continuing prescription medications during pregnancy. (image credit) Here's the start of this AP article:

Philadelphia - Doctors aren't doing a very good job of warning young women to avoid getting pregnant when they're taking prescription drugs that can cause birth defects, a new study suggests.

Nearly half of the women taking the medicines didn't get counseling from their doctor about using contraceptives or other birth control measures, University of Pittsburgh Medical Center researchers found in a study of nearly 500,000 women.

Now, this didn't make any sense to me. I get asked a lot about prescription meds during pregnancy by my patients. And, I know during medical school and residency training, the issue of meds during pregnancy is emphasized heavily.

Later in the article, the glaring limitation of this study is exposed...

The researchers noted that the study might overestimate the problem because the data is from health plan billing codes, which don't have the same detailed medical histories as patient medical charts. Some doctors may have provided counseling but didn't bother to mark it with a billing code.

Ah HA! Of course, this study overestimates the problem - thereby falsifying their data. What kind of researcher would use billing codes from a physician office to track counseling? Everyone knows that insurance companies do not pay for most (if not all) counseling sessions done my medical physicians. That's the reason they're on on the billing form.

Now, some of you out there are probably saying, "Those greedy doctors. If they don't get paid for counseling, then they won't do it." On the contrary, counseling does happen. It's documented in the medical record (which the researchers here didn't bother to check). In addition, since insurance companies don't pay a counseling charge, as with other charges not paid by insurance, the bill would subsequently go to the patient. Who wants that to happen?

Don't get me wrong. Docs can do a better job in discussing medication reactions in pregnant patient. But, to come out and accuse docs of doing a bad job for patients and then have bad research data? That's disingenuous and lying to the public, but par for the course for the American press.