David Fassler, M.D.: "We have clear and consistent data that
[direct-to-consumer advertising] has a significant impact on patient requests
for specific medications and on the prescribing patterns of
physicians." Ted Grudzinski/American Medical Association
The AMA will advocate for dropping a section of the U.S. Patriot Act that
allows the government to seize patients' medical records while also
prohibiting physicians from informing patients about the seizure.
If those sections are renewed by Congress, they should be amended
substantially to better protect medical privacy and patient confidentiality,
according to an AMA Board of Trustees report approved by the AMA House of
Delegates at its annual policymaking meeting last month in Chicago.
The report was written in response to a resolution brought to the house
last year by APA and the American Academy of Child and Adolescent Psychiatry
Section 215 of the Patriot Act provides that the FBI may require production
of "tangible things" (including books, records, papers, documents,
and other items) for an investigation to protect against international
terrorism or clandestine intelligence activities. The act further states that"
[n]o person shall disclose to any other person... that the FBI has
sought or obtained tangible things under this section."
At the AMA's interim meeting last December, then APA President-elect Steven
Sharfstein, M.D., told delegates that the Patriot Act is unique from other
laws requiring disclosure of patient records because of what amounts to a gag
order—a provision forbidding the physician from informing the patient or
anyone else that records have been taken.
"It would mean the treatment relationship would have to end,"
The section is scheduled to "sunset" at the end of 2005. The
AMA board report suggests that if the section is not dropped altogether, it
should be amended in any of the following possible ways:
Despite some testimony during reference committee hearings that counseled
caution when treading on matters related to national security, the House of
Delegates passed the report without debate. It was one of a number of items of
importance to psychiatry that were readily approved—a sign, APA leaders
say, of the continuing and growing influence within the house of medicine of
the psychiatry delegation. (See related stories elsewhere in this issue: AMA
actions regarding SSRIs in children and adolescents on
page 1; and on suicide
and depression on college campuses and pay for performance on facing
John McIntyre, M.D., chair of the Section Council on Psychiatry and head of
APA's delegation, said the action taken by the house on the Patriot Act is
evidence of the AMA's staunch defense of medical privacy.
"This was really an issue affecting the doctor-patient relationship,
and it demonstrates the willingness of the AMA to stand in defense of that
relationship even in the face of controversy," he said.
The board report states, "Even without hard data, it can be assumed
the act will cause some patients to avoid seeking care or to be less than
forthcoming in the physician's office. Quality of care may suffer. Unable to
protest or even publicly acknowledge a disclosure, medical professionals stand
to lose the trust and confidence of their patients and undermine the
These are other items of interest to psychiatry on which the House of
More information about these and other actions taken at the AMA's
2005 annual meeting are posted online at<www.ama-assn.org/ama/pub/category/14887.html>."
Enhanced Physician Access to Food and Drug Administration Data"
is posted online at<www.ama-assn.org/meetings/public/annual05/csa6a05.doc>.▪