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Ami Bera, MD Headshot

Can We Get the Government Out of Our Exam Room?

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Last week, Congressman Darrell Issa of California chose to review whether it was appropriate for President Barack Obama's administration to mandate that insurance companies cover oral contraception. This week, Sen. Roy Blunt of Missouri introduced legislation that allows any insurance company or any employer to decide what it wants to offer in terms of health insurance coverage. And Rep. Dan Lungren argued that companies had the first amendment right to deny their employees access to these medical services.

My frustration is that none of the above-mentioned individuals has ever gone to medical school. They have never sat with a patient and her family and helped navigate healthcare decisions that may have life and death implications. In short, why are individuals with no healthcare expertise about to decide how a doctor takes care of their patients?

I have been a doctor for more than 20 years. I love the opportunity to help my patients, to work with them to find the best course of action to get them healthy and to give them the information they need to stay healthy.

When I took the Hippocratic oath, and was effectively 'sworn in' as a doctor, I took the same vow that doctors have taken for generations. Patient autonomy is core to this oath. As a doctor, I have committed myself to provide my patients with the best options available and to explain the risks and benefits of those choices. At that point, it is up to my patients to make the best decision that respects their own faith, family and personal circumstances. I take that oath very seriously -- as do the thousands of doctors and medical care providers in this nation.

Members of Congress take their own oath when they are sworn in as elected leaders. They swear to uphold the Constitution, and to defend it against all enemies. But nowhere in their oath of office are they required to protect the medical health and well-being of their constituents.

That fact was driven home to me over the last few weeks as I watched members of Congress play politics with the health and well being of the women in this country.

I have heard the charge from Congressional Republicans that requiring health insurance companies to provide access to oral contraception is an encroachment on religious freedoms. I fear this misses the point. As a physician, I would never encroach upon the religious freedoms of my patients. As mentioned, the oath I swore explicitly requires that I respect patient autonomy. My job as a physician is to make sure I have provided my patients with the best options to make the decisions that affect their lives.

Patient autonomy is paramount to the oath that we take when we enter the profession of medicine. That is why I am appalled when the federal government gets between my patients and their right to the full range of medical information and complete access to health care. Only when fully informed, with all options in front of them, can a patient truly have what she needs to make a fully informed decision -- and to exercise their personal right to religious freedom. In fact, the arguments advanced by congressmen Issa and Lungren are an encroachment on the individual liberties of my patients.

For the record, I believe that women and their doctors should have access to oral contraception when desired by the patient and medically appropriate. I also think unfettered access to these medications improves health, reduces illness, and is cost-effective. This is good medicine and meets the community standard of care that dictates how we practice medicine.

It is not my duty to force oral contraception on my patients, any more than it is a politician's duty to limit access to medically accurate information and a full range of health care options.

It is time that we got the government out of our exam rooms. Yes, the government will have a role, as will the private sector, in determining the amount of resources that we have available to make sure every American has reasonable healthcare coverage. But once we understand the resources that are available, let's leave the business of delivering healthcare to those that have experience doing it.

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