Courtesy photo / American Medical Association President Dr. Andrew Gurman (center) says the association has heard from doctors who “felt very pressured by hospital administration to make sure” survey scores were good.

Courtesy photo / American Medical Association President Dr. Andrew Gurman (center) says the association has heard from doctors who “felt very pressured by hospital administration to make sure” survey scores were good.

The American Medical Association — whose president is Altoona doctor Andrew Gurman — has helped to eliminate one of the factors the AMA blames for the national opioid epidemic.

Because of lobbying by the AMA and other groups, the Centers for Medicare and Medicaid Services has agreed to reconfigure three CMS hospital survey questions that ask if patients need medicine for pain, if the pain was well controlled and if the hospital did all it could to help.

Because answers that indicate anything less than complete satisfaction result in diminished hospital performance scores that in turn reduce hospital reimbursements from CMS, the questions encouraged doctors to overprescribe, according to the AMA.

Overprescribing opioids “is a key driver of America’s drug-overdose epidemic,” the Centers for Disease Control stated in a news release in March.

Opioid overdose killed 29,000 people in 2014, 64 percent of them from prescription drugs, according to information provided by the American Society of Addiction Medicine.

Most of the patients treated by doctors for opioid addiction get hooked on prescription meds, then transition to heroin, mainly because it’s 10 times cheaper, according to a March 18 article from the AMA.

When a hospital patient who wants paid meds doesn’t get them, “they’re not at all happy, (and) it sets up the potential for conflict” — for doctors — between what is good for society (and the patient) and what is good for the hospital, Gurman said.

The AMA has heard from doctors who “felt very pressured by hospital administration to make sure the scores were good,” Gurman said.

“Doctors feel they have been caught in the middle,” he added.

Getting docked 2 or 3 percent on CMS reimbursements can inflict serious financial injury on a hospital, given that revenues may exceed expenses by those very same percentages, Gurman said.

The Pain News Network is unhappy about what it believes is the CMS surrender to groups like the AMA.

“CMS has been under intense political pressure,” the group said in a July 7 article, after the CMS first proposed eliminating the pain questions. “While some politicians and lobbyists may support the CMS decision, pain patients clearly do not.”

A PNN survey showed nine of 10 pain patients believe they should continue to be asked, while more than half rated hospital treatment of pain as inadequate, according to the article.

CMS will develop alternative questions for the survey, Gurman said.

“There are still ways that people can say they’re not happy,” he said. But the new questions won’t specifically ask about pain and pain management, he said. That doesn’t mean doctors won’t continue to provide patients “who live with acute and chronic pain … compassionate care,” he said.

Mirror Staff Writer William Kibler is at 949-7038.