Principles of Health Care Delivery and Practice

Health Care in the United States is changing, for better and for worse. As clinicians, citizens and patients, we are committed to maintaining and improving the health of our patients and communities.

We are deeply concerned about the changes for the worse regarding limits to access, profits made by health care organizations that drain resources away from patient care, the distortion of clinical decision-making by financial considerations, and the squandering of valuable and finite resources on paperwork and bureaucracy. We offer these principles as fundamental components of health care practice and organization.

I. Health Care Broadly Defined

We define health care broadly to include the prevention, diagnosis, treatment and management of illness including medical, surgical and mental.   We consider health promotion, rehabilitation, and palliation as essential services.

Health care organizations and institutions should exist primarily to
improve the health of patients.

II. Access

Health care should be accessible to all regardless of employment,
education, social, economic cultural or linguistic status. Financial,
geographic, and organizational barriers should not limit access to care.  The ability to creatively and appropriately employ scientific and technologic innovations in the interests of patients should be facilitated and enhanced by health care organizations and institutions.

III. Choice

Patients must have the right to choose their health care organizations
and their clinicians within these organizations.

IV. Confidentiality

Personal medical information must be confidential and accessible, in a timely fashion and with the patient's permission, only to those responsible for the patient's care and only in the patient's interest.

V. Responsible Health Care Organizations

There should be no profit made from the care of patients.  Health care organizations are accountable first and foremost to the patients they serve. Any resources saved by system efficiencies and improvements should be reinvested in the care of patients and not returned to investors.  Competition among health care organizations is helpful only when it improves the care of patients.

VI. Responsible Professionals and Patients

As professionals and patients, we must responsibly allocate the finite resources available for health care. The legal, ethical and moral obligation of clinicians to provide care in accordance with the highest professional standards is fundamental. Those who take action to correct conditions that prevent safe practice or high quality patient care must not suffer discipline or dismissal for their actions.

VII. Disclosure

There should be full disclosure available to patients and the public of the
financial arrangements between health professionals and health care
organizations and between organizations and for-profit corporations.
The licensure and job title of every person providing direct care should
be clearly evident to patients and family.

VIII. Quality and Peer Review

Health care should be subject to review by peers and the public. This
includes easy access for patients and clinicians to expert and second
opinions.

IX. Research and Training

Research and professional training are essential to the long-term vitality
of our health care system. Both require the explicit support of all health
care organizations and local, state and federal governments.

X. Simplicity and Clarity

Health care should be delivered and paid for in the simplest fashion
possible. Repetitive and complex paperwork, administrative delays,
and confusing forms distract clinicians from the care of patients and are
unnecessary barriers to the effective and efficient delivery of health care.