State Laws Are Reaching Into The Exam Room To Interfere With Doctors And Their Patients


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Across the country, a web of politically motivated laws influence the way that doctors are allowed to interact with their patients.

As detailed in a new report entitled “Politics in the Exam Room,” medical professionals in a growing number of states must navigate restrictions that govern the way they can address issues like reproductive health, gun safety, and toxic chemical exposure.

Proliferating anti-abortion laws, for instance, prevent doctors from using their best medical judgment to treat their patients. Arizona and Arkansas have new requirements requiring providers to tell pregnant women about an unproven and unscientific method of “reversing” an abortion.Kansas and Oklahoma recently banned the most popular — and safest — form of second-trimester abortion procedure for no medical reason. Other states have attempted to redefine the medical terms of pregnancy and mandated alternative protocols for administering medication, all over the protests of doctors in the field.

Thanks to the pro-choice groups that often rely on slogans like “politicians make crappy doctors,” this concept is not entirely unfamiliar in the realm of reproductive rights. But this week’s report makes the case that the issue also extends beyond abortion access.

And in 2011, Florida became the first state in the country to pass a so-called “physician gag law” that bans doctors from asking their patients about guns — a policy that was upheld by a federal court last summer. Since then, the NRA has pushed similar measures in states like Alabama, North Carolina, West Virginia, Minnesota, Texas, and Oklahoma.

Doctors say these types of proposals undermine their professional obligation to talk to their patients about how to keep themselves healthy and safe. The American Medical Association, the largest association of physicians in the country, has issued multiple policy statements urging more transparent information about fracking chemicals and instructing doctors to provide counseling about gun safety.

“Lobbyists and powerful corporations are intruding into the exam room in order to protect their own interests,” Dr. Sarah Kimball, a practicing physician in Boston who chairs a task force on gun violence prevention for the National Physicians Alliance, told ThinkProgress. “I think a lot of patients are really not aware this is going on.”

That’s why advocates from a wide range of different medical groups, women’s health groups, environmental groups, and gun violence prevent groups have all joined together to fight to preserve the patient-provider relationship from outside influence.

“It’s an unprecedented coalition, and I think that really speaks to the depth and breadth of this growing problem we’re seeing,” said Sarah Lipton-Lubet, the director of reproductive health programs at the National Partnership for Women & Families, the organization that spearheaded the new report. “We thought it was really important to come together and expose what was happening here.”

In Kimball’s own work as a primary care doctor at an urban safety net hospital in Boston, she sees patients every day who are suffering from the long-term effects of gun violence. They may be dealing with chronic pain, paralysis, or psychological trauma as the result of getting shot. In response, she thinks it’s her responsibility to talk to them about how to safely store and handle firearms — and she bristles at the potential for what she describes as “corporate interests taking precedent over patients” to impede those conversations.

“If there’s one way to get physicians up in arms and get them willing to stick their necks out, it’s to get in the way of what we think is best for our patients,” Kimball said. “There’s no space for politics in the exam room. We’re hoping to coalesce around that issue.”


Reprinted with permission from Think Progress, a branch of The Center for American Progress