News in brief - June 23, 2003

Wisconsin malpractice compensation fund to stay intact - Columbia group and PRN join forces - Washington doctors rally for reform - New damage caps study released - Florida OKs organ donation law - California family physicians pick new leaders - Toronto medical students cope with SARS

Wisconsin malpractice compensation fund to stay intact

Wisconsin lawmakers won't let Gov. Jim Doyle take money from the state's Patient Compensation Fund -- which physicians say is a major player in keeping their medical liability insurance rates stable -- to offset a budget deficit.

The Legislature's Joint Finance Committee in June did not approve Doyle's proposal to take $200 million from the fund to help compensate for a $454 million budget shortfall. Physicians, hospitals and other health care professionals have paid into the fund annually for more than 25 years. The state uses the money to pay damages in medical malpractice lawsuits that exceed what liability insurance policies cover.

Physicians lobbied against raiding the fund because they say it is a key reason the state has stayed on the AMA's "OK" list during a national medical liability insurance crisis. Wisconsin is one of only six states to get that designation.

"Wisconsin physicians and citizens are relieved that our state's excellent health care system will remain strong because Republican legislators have rejected one of the most destructive ideas in Gov. Doyle's budget," said John E. Patchett, the Wisconsin Medical Society's CEO. "Republican legislators recognized that it made no sense to tamper with Wisconsin's successful medical liability system."

Columbia group and PRN join forces

Physicians for Responsible Negotiation -- a no-strike physician union originally created by the American Medical Association -- will advise and consult with the Society of Practitioners, who make up the majority of Columbia Presbyterian Medical Center's practicing medical faculty in New York.

The groups will work together to improve physician working conditions to best provide quality patient care and will negotiate changes in employment terms to retain the "highest quality physicians, researchers and educators on the Columbia faculty," according to a joint statement from the groups.

Washington doctors rally for reform

About 2,600 physicians, patients and health care professionals in Washington state rallied in Seattle, Spokane, Walla Walla and Pullman May 29 to get across their message that tort reform needs to be passed during the Legislature's special session in order to ensure patients continue to have access to the care they need. About 1,200 physicians and others participated in rallies in other Washington cities earlier in May.

Washington is one of 18 states the American Medical Association says is experiencing a liability insurance crisis because physicians are retiring early, discontinuing high-risk services or moving to other states. For example, six of nine obstetricians in Mount Vernon, Wash., stopped delivering babies or left the area this year. And the number of ob-gyns delivering babies in Tacoma has been cut in half this year, to 10 from 20.

Physicians in Washington, like those in other states, support a cap on noneconomic damages.

New damage caps study released

Noneconomic damage caps haven't prevented "sharp increases" in liability insurance premiums for internists, general surgeons and ob-gyns between 1991 and 2002, according to an analysis by Weiss Ratings Inc., a Florida-based, independent company that provides rating and analysis of financial services companies, mutual funds and stocks.

The study, which used data collected by the Medical Liability Monitor, found that 19 states that implemented caps during the study period saw a 48.2% increase in median premiums. In 32 states without caps, premiums increased by 35.9%, according to the study.

However, the Weiss study also concluded, based on an analysis of data from the National Practitioner Data Bank, that insurers in states with caps on noneconomic damages saw a slow-down in their payouts during that time. States without caps saw a 71.3% increase in the median payout between 1991 and 2002; states with caps saw a 37.8% increase in median payouts, according to the study.

Florida OKs organ donation law

The Florida Legislature passed the Nick Oelrich Gift of Life Act prohibiting family members, guardians, or health care surrogates from changing an adult's decision to be an organ donor. The law is named after the deceased son of the Alachua County sheriff,

The new law also states that a donor cannot revoke an anatomical gift by making an oral statement to a spouse. Oral revocation is allowed if it is made to two people, one of whom cannot be a family member.

The act passed by a 38-0 vote in the state Senate, a 91-24 vote in the state House of Representatives, and was signed by Gov. Jeb Bush on May 27. The law goes into effect July 1.

California family physicians pick new leaders

The California Academy of Family Physicians recently named its 2003-04 officers.

Emily Ebert, MD, of Colton, Calif., was installed as president, and Dana Ware, MD, of Chester, was named president-elect. Richard Zachrich, MD, of Santa Monica, was installed as immediate past president.

Elected speaker was Eric Ramos, MD, of Modesto, while Bo Greaves, MD, of Santa Rosa, was chosen as vice speaker. Carla Fulton Kakutani, MD, of Winters, was installed as secretary-treasurer.

The six officers were elected at the academy's 55th Annual Scientific Assembly in Los Angeles. The academy has about 7,000 members and is the largest chapter of the American Academy of Family Physicians.

Toronto medical students cope with SARS

The second wave of severe acute respiratory syndrome to hit Toronto could have done serious damage to the curriculum for next season's fourth-year University of Toronto medical students when teaching hospitals closed their doors to nonessential personnel for the second time this spring.

However, unlike the first time SARS struck the city, medical school officials were able to convince hospitals to include medical students as medical team members, allowing them to stay in their clinical rotations.

"We used up what leeway we had, so this was a tremendous relief," said Rick Frecker, MD, associate dean for the University of Toronto Faculty of Medicine.

That leeway was a six-week clinical period that was missed by third-year students when the hospitals closed their doors to students from March 29 until May 12. To make up for this lost curriculum, the school moved an elective clerkship formerly scheduled for after the national resident match. The clerkship will now take place at the beginning of the fourth year.

Other students had fewer disruptions in their education. Current fourth-year students graduated without a hitch, though they were given a congratulatory nod instead of a handshake upon receipt of their diplomas.

First- and second-year students had interruptions to clinical experience that were made up with additional lectures. However, third-year medical students missed an entire clerkship when teaching hospitals restricted access.

If the third-year students had missed more hospital time with the second SARS outbreak, faculty would have been hard-pressed to figure out how to cram in the lost training without lengthening the academic year.

Continuing medical education has also suffered in Toronto, though the ban on groups' gathering has been lifted.

Of the 10 courses canceled this spring, four have been rescheduled, according to Dave Davis, MD, dean of continuing medical education for Toronto's Faculty of Medicine.