News in brief - May 26, 2003

Commission focuses on diversity among health care workers - ACCME alters accreditation policy - New group offers accreditation for human research programs - Calif. medical board begins collecting physician data - Number of incisions at issue in N.Y. payment lawsuit - Mich. abortion law language clarified - Some medical problems appear global

Commission focuses on diversity among health care workers

Addressing health care disparities between minorities and whites is the focus of a new commission convened by former U.S. Secretary of Health and Human Services Louis Sullivan, MD.

The Sullivan Commission on Diversity in the Healthcare Workforce will meet this year to address how to increase the number of underrepresented minorities in health care professions.

"Studies show minority physicians have a greater likelihood of settling in areas with minority citizens," Dr. Sullivan said. "So if we want to bring health care services to the medically underserved, we need to increase the number of minority doctors."

Sullivan said that because minorities as a group tend to be less healthy than whites as a group, they have a lower quality of life, generate higher health care costs and contribute less to the economy, all reasons society would benefit from improving minorities' health care.

Dr. Sullivan said one of the problems the commission will evaluate is how to improve access to medical education, which is considered out of reach by many minority families. Sullivan said the average medical school debt is near $100,000, while the average black family's income ranges from $30,000 to $40,000.

During the next year, Dr. Sullivan, along with health care experts, business leaders and other commission members, will hold hearings in Atlanta, Chicago, Denver, New York, Los Angeles and Houston to develop a sense of the regional issues.

The commission will release its recommendations in spring 2004 and will gear them toward what Congress and the private sector can achieve. Former U.S. Sen. Bob Dole (R, Kan.) and former U.S. Rep. Paul Rogers (D, Fla.) will be honorary co-chairs of the commission.

The commission is being funded by the W.K. Kellogg Foundation and administered by Duke University School of Medicine.

ACCME alters accreditation policy

The Accreditation Council for Continuing Medical Education rescinded its policy that prohibited provisionally accredited providers from jointly sponsoring CME activities with nonaccredited educational partners.

Effective May 1, the ACCME now allows all accredited providers to jointly sponsor CME activities with nonaccredited educational partners. All current and future provisionally accredited providers are allowed to act as the responsible, accredited provider in a joint sponsorship relationship. More information on the compliance requirements for jointly sponsored activities, is available on the ACCME Web site (www.accme.org/whatsnew/sec_new_nw1_237.asp).

New group offers accreditation for human research programs

The Assn. for the Accreditation of Human Research Protection Programs has awarded accreditation to its first two institutions, the University of Iowa in Iowa City and the Western Institutional Review Board in Olympia, Wash.

Accreditation with the organization is voluntary and is valid for three years. Accredited organizations submit annual reports to AAHRPP on the status of their human research protection programs.

The AAHRPP, incorporated in March 2000, was launched following a federal report recommending independent, nongovernmental accreditation be established to certify that research programs follow strict standards to protect research subjects.

Calif. medical board begins collecting physician data

The Medical Board of California has started gathering demographic data on all licensed California physicians.

A state law passed in 2001 requires the board to keep track of information such as each physician's specialty, training history and percent of time spent on patient care, according to the California Medical Assn. The state will use the data to address patient-access and physician-supply issues.

Doctors are receiving a demographic survey in the mail. The CMA urges physicians to complete and return the survey quickly so current data will be used to guide public policy decision-making. Data will be updated at the time of each license renewal.

Number of incisions at issue in N.Y. payment lawsuit

New York orthopedic surgeons are suing Empire HealthChoice Inc., accusing the health plan of not paying them for multiple medically necessary procedures performed through a single surgical incision. If the surgeons were to make multiple incisions, they could ask to be reimbursed for multiple procedures.

Howard J. Luks, MD, Richard M. Magill Jr., MD, and Iris E. Schlesinger, MD -- who all practice in Valhalla, N.Y. -- filed the lawsuit on behalf of all New York orthopedic surgeons. They are asking the court to stop Empire's "multiple incision" policy, and they are asking that physicians be paid for the surgeries.

Mich. abortion law language clarified

Abortion providers say a lawsuit settlement clears up vague wording in a new Michigan law that they fear would have prohibited physicians and clinics from receiving prompt payment for pregnancy tests, ultrasounds and other services women need before they decide whether they will have an abortion.

The law was aimed at protecting women from being financially pressured into having an abortion, but the Center for Reproductive Rights, which filed the lawsuit on behalf of several Michigan reproductive health care practitioners and facilities, said the law's language was confusing and contradictory and that it would have put physicians at risk of losing their licenses or paying fines.

"The settlement achieves plaintiffs' goals: to ensure their ability to continue to provide reproductive health care services to women and to enable them to be paid for services that they provide without jeopardizing their patients' ability to obtain the medical services that they desire," Bebe Anderson, an attorney with the Center for Reproductive Rights, said in a statement.

Michigan also is happy with the clarified wording that bans any "pre-payment" for an abortion prior to the 24-hour waiting period. The settlement also requires that patients sign a consent form before having an abortion. "With this agreement, women will be safeguarded against abortionists who seek to trap them financially into having an abortion procedure," Michigan Attorney General Mike Cox said in a statement.

Some medical problems appear global

Medical errors, lack of care coordination and poor communication appear to be international problems, according to a Commonwealth Fund/Harvard/Harris Interactive survey of patients with health problems in the United States, Canada, United Kingdom, Australia and New Zealand.

Results of the study were published in the May-June Health Affairs and showed that 28% of the U.S. patients reported being the victim of a medical error in either treatment or medication, compared with 25% in Canada, 23% each in Australia and New Zealand, and 18% in the United Kingdom.

Lack of care coordination resulted in 22% of the U.S. patients being sent for duplicate tests, compared with 20% in Canada, 17% in New Zealand and 13% each in Australia and the United Kingdom.

Communication, quality and cost concerns were all linked when it was discovered that many patients, without telling their doctors, discontinued taking prescribed medications because of side effects. This happened with 19% of the U.S. patients, 17% of the Canadians, 16% of the U.K. patients, 16% of the New Zealand patients and 15% of the Australian patients.