Physicians' Group Protests HMO Decision on Internists.

A physicians' group is protesting a Michigan health maintenance organization's decision to force members to stop using internal medicine doctors as their primary-care physicians.

The American College of Physicians-American Society of Internal Medicine said it opposes a move by Care Choices HMO to disallow the use of internal medicine specialists as primary-care physicians among some of its members.

ACP-ASIM said Care Choices sent notices to its members in the Muskegon, Mich., area, telling them they must select a new primary-care physician if the one they use is a specialist in internal medicine.

Caroline Albert, a spokeswoman for ACP-ASIM, said Care Choices is instituting the policy only in a small service area in western Michigan--Care Choices serves 22 counties in Michigan--but the physicians' group is concerned the HMO may try to expand the practice.

Care Choices' Web site states that members must select a primary-care physician, and that physician could bean internist. Albert said the ACP-ASIM is concerned Care Choices is adjusting its policy for economic reasons.

She said the physicians' group "has a long-standing policy of opposing managed-care organizations' attempts to restrict access to primary-care physicians based solely upon specialty."

John P Dumoulin, ACP-ASLM's director of managed care and regulatory affairs, said in a statement that not allowing the use of internists as primary-care physicians for adults is equivalent to restricting pediatricians for children. "Internists provide a broad range of medical services, ranging from generalized adult medicine to subspecialties including geriatrics, infectious diseases and oncology," Dumoulin said. "Adults suffering from multiple or chronic diseases often require the regular services of internists to manage their care."

Care Choices is a subsidiary of Trinity Health, a system comprising 44 hospitals and other health-care organizations in seven states that was formed by the consolidation of Mercy Health Services and Holy Cross Health System.