News in brief - April 21, 2003

CMA taps new leaders - Texas House supports liability caps - On-call coverage problem in Calif. - Most hospitals disclose harm

CMA taps new leaders

Ronald P. Bangasser, MD, a family physician in Redlands, Calif., was installed as president of the California Medical Assn. Robert E. Hertzka, MD, a San Diego anesthesiologist, was chosen president-elect.

Both doctors took office during the CMA's annual meeting in March.

Dr. Bangasser, 53, serves as director of external affairs for Beaver Medical Group. He has been active in state and national medical societies for nearly 30 years, as speaker and vice speaker of the CMA house of delegates and as past president of the San Bernardino County Medical Society.

Dr. Hertzka, 46, works in obstetrical anesthesiology at Sharp Mary Birch Hospital for Women in San Diego, and is an assistant clinical professor at University of California, San Diego School of Medicine. He has chaired the CMA's political action committee since 1999 and served as a member of the CMA board of trustees for nine years.

He is past president of the San Diego County Medical Society.

Texas House supports liability caps

Two-thirds of the Texas House of Representatives in late March voted in favor of a constitutional amendment to allow the Legislature to cap noneconomic damages -- commonly known as pain and suffering damages -- in medical liability lawsuits.

The Texas Senate would need to approve a companion bill -- and the governor would then have to sign it -- before the state's voters would be asked to approve an amendment that would allow the caps.

Physicians say there needs to be a $250,000 cap on noneconomic damages to keep medical liability insurance rates affordable. Trial lawyers disagree, saying that the focus should be on insurance regulation.

On-call coverage problem in Calif.

The California Medical Assn. says hospitals in the state lack adequate on-call coverage for their emergency departments.

A recent CMA survey of member physicians showed that 75% consider on-call coverage a problem at their hospitals. Specifically, 33% said the lack of on-call physician backup for EDs was very serious, while 42% said it was somewhat serious.

One-third of respondents said their hospitals had a voluntary on-call policy, compared with 47% with a mandatory policy and the remainder, which rely on hospitalists or third-party services.

The CMA holds that physician participation on a hospital emergency department on-call panel should be voluntary and not a requirement for staff membership. It also encourages hospitals to contract with physicians for on-call services and to compensate such emergency service.

Family physicians said they received stipends ranging from $80 to $1,000 a day for on-call coverage; internal medicine, $80 to $800; ob-gyn, $65 to $1,400; and pediatrics, $100 to $1,000.

Most hospitals disclose harm

Most hospitals disclose harm caused to patients at least some of the time, according to a report written by Harvard University researchers and Donald M. Berwick, MD, president of the Boston-based Institute for Healthcare Improvement, published in the March/April Health Affairs.

Of the 245 hospitals responding to a survey, 55% reported it was routine practice to tell a patient or their family if they had been harmed by care. Another 44% said disclosures occurred some of the time, while 5% said they did not disclose harms.

The form of disclosure usually included an explanation (92% of the time), undertaking an investigation (87%), an apology (68%), an acknowledgment of harm (66%), a promise to share results of investigation (41%), and taking responsibility for harm (33%).

Only 36% of hospitals reported having an established policy regarding disclosure, but 44% said such policies were under development.