AMA chief says arbitration pacts up to patients, doctors

Thursday, Aug. 14, 2003 | 9:37 a.m.

CARSON CITY -- The American Medical Association does not have a policy against doctors signing binding arbitration agreements with patients, the president of the organization said.

Dr. Donald Palmisano, AMA president, said he needed to set the record straight because another organization had misrepresented the medical association's policy regarding binding arbitration.

"Under Nevada law, physicians and patients have every right to decide for themselves whether to sign an arbitration agreement," he said.

Some Clark County physicians have been asking their patients to sign agreements to go to binding arbitration rather than filing a lawsuit over any dispute with their doctors. A retired judge or attorney would hear the case, rather than a jury.

In an Aug. 5 press release, the Center for Justice and Democracy said forcing patients to sign mandatory binding arbitration agreements as a prerequisite for a patient to receive medical treatment is a "direct violation of AMA policy, which says that such agreements are fundamentally unfair to patients."

The center said that conclusion was part of a 1998 report released jointly by a commission composed of members of the AMA, the American Bar Association and the American Arbitration Association.

The report said: "Consent to use an alternative dispute resolution process should not be a requirement for receiving emergency care or treatment. In disputes involving patients, binding forms of dispute resolution should be used only when the parties agree to do so after a dispute arises."

Dr. Rudy Manthei, a Las Vegas physician who leads an organization called "Keep Our Doctors in Nevada," said that agreement referred only to doctors who were hired by HMOs. The AMA has no problem with physicians in private practice requiring these agreements with a patient. The HMOs were trying to protect themselves from lawsuits, Manthei said.

The commission's goal was to "make recommendations as to how alternative dispute resolution should be used to provide a just, prompt and economical means of resolving disputes over access to health care treatment, and coverage, in the private health plan/managed care environment," according to its mission statement.

Joanne Doroshow, executive director of the Center for Justice and Democracy in New York City, agreed that the commission studying arbitration was looking into the "managed care environment" but added that virtually all physicians were involved in that system.

The report noted that 75 percent of Americans with private health insurance are enrolled in some form of managed care system.

She said, "The finding (by the commission) on due process makes no distinction as to what kind of health care provider they apply."

"Moreover, it's simply incredulous for Dr. Palmisano, who served on this commission and developed this policy, to say that it's a violation of someone's due process for an HMO to force arbitration on a patient to get medically treated, but it's OK for a physician to do this," Doroshow said.

The commission recommended that arbitration "can and should be used to resolve disputes over health care coverage and access arising out of the relationship between patients and private health plans and managed care organizations."

But it also said these forms for binding arbitration should be used only after there is a complaint by the patient about a possible case of malpractice.

"It is essential that due process protections be afforded to all participants in the alternative dispute resolution process," said the joint commission of doctors, lawyer and arbitrators.