LONG BEACH, Calif--The Office of Technology Assessment recently
gave a rather harsh assessment of the performance of the Agency
for Health Care Policy and Research (AHCPR), stating in its report
that the agency has been largely unsuccessful in evaluating treatments,
in preparing practice guidelines, and in saving significant health-care
dollars, said Samuel Turner, an attorney with Fox, Bennett &
Turner, Washington, DC.
Physicians are seeking protection from medical malpractice claims
through the use of practice guidelines, and, in fact, some states
have established affirmative defenses against malpractice claims
for physicians who are able to show that they followed approved
guidelines, Mr. Turner said at the 1995 Quality of Life Symposium,
sponsored by St. Mary Medical Center.
The question arises whether outcomes assessment and practice guidelines
should emanate from the Federal government through the AHCPR or
from private sources such as medical societies, he said.
In its 5 years of existence, the agency has completed only 15
practice guidelines, at a cost of roughly $1 million per guideline.
In contrast, the private sector has completed more than 1,500
practice guidelines at an average cost of $100,000 or less.
The combination of seeming inefficiency and high cost of the agency's
performance makes it a primary target for budget cuts. "And
so I think we're in an environment where the private sector is
poised to pick up the cudgel and do the job of health services
research where perhaps AHCPR has fallen short," he said.
He feels that the only area of legal concern to the private sector
in drawing up guidelines is the Federal antitrust law, which,
in general, forbids competing entities from colluding to develop
collective policies that might impact on how they do business.
A guidance issued last year by the Federal Trade Commission and
the Department of Justice, which share antitrust jurisdiction,
created, in effect, a safe harbor for practice guidelines, he