News in brief - July 28, 2003

CIGNA on track to settlement - Wyoming added to medical-liability crisis list - ACGME allows some specialty-related changes to duty-hour rules - Family physicians to distribute new waiting room publication - Illinois medical liability fight to be reenergized

CIGNA on track to settlement

CIGNA Corp. expects to settle class-action lawsuits by the beginning of September that physicians filed against the company for the way it processes physician claims.

The company's attorneys told U.S. District Judge Federico A. Moreno in the Southern District of Florida, Miami Division, on July 8 that they continue to make progress in mediation and believe they will be able to present the court with an agreement in the next 30 to 40 days, CIGNA spokesman Wendell Potter said. Moreno set a Sept. 4 hearing date.

Wyoming added to medical-liability crisis list

Wyoming was added in July to the American Medical Association's list of states in the midst of a full-blown medical liability insurance crisis, making it the 19th state to be declared a crisis state.

The AMA says that patient care is being hurt in Wyoming -- already ranked 47th in the nation for its physician-population ratio -- because doctors are leaving the state to practice where they can find lower insurance premiums, retiring early because of high premiums or giving up high-risk procedures in an effort to lower insurance premiums.

ACGME allows some specialty-related changes to duty-hour rules

Board members of the Accreditation Council for Graduate Medical Education fined-tuned resident duty-hour requirements at their June meeting, allowing some specialties limited flexibility in such areas as the six-hour post-call period. They also approved the creation of a new psychiatry subspecialty in psychosomatic medicine.

The ACGME denied a request from neurosurgeons for a specialtywide exception to expand their hour limit to 88 hours per week from 80 per week, averaged monthly.

As it stands, individual programs must show they have sound educational reasons to be considered for an exception of up to 10% of the 80-hour limit. Each program must petition its Resident Review Committee for such a change.

The ACGME approved the following specialty-specific changes to its work hour limits: Anesthesiology, diagnostic radiology, emergency medicine, family medicine, neurology, nuclear medicine and pediatrics will not permit any exceptions to the 80-hour weekly limit. For family practice programs activities during the six-hour transition period following 24-hour call may include on-site rounds of continuity patients on the inpatient service, the transfer of patient care, program conferences, self-directed activities or scheduled continuity office hours. Residents may not have continuity office hours in the afternoon or evening following an overnight call period.

Since residents are not permitted to see new patients after finishing call, the ACGME allowed several specialties to further define what they consider a new patient to be. For example, pediatrics and family medicine consider patients who are part of the resident's continuity panel as permissible exceptions to the "no new patients rule." Surgery and orthopedic surgery consider a new patient to be any patient who is new to the institution.

Family physicians to distribute new waiting room publication

The American Academy of Family Physicians will publish a new consumer health magazine for patients to read in family physicians' waiting rooms.

The publication, Family Doctor: Your Essential Guide to Health and Wellbeing, will focus on health and wellness issues for the whole family. It will be updated annually with the latest information on treatments and medicines for common conditions and health concerns, including diabetes, allergies, hypertension and heartburn.

Up to 20 copies of Family Doctor will be sent free to AAFP member-physician practices. The copies can be given to patients or used in waiting rooms. Distribution will begin in the first quarter of 2004.

Non-AAFP members can purchase Family Doctor through the AAFP's consumer Web site (www.familydoctor.org).

Illinois medical liability fight to be reenergized

For about a decade, the Illinois State Medical Society has been working to remove physicians from the state's execution chamber. This year, the Illinois General Assembly passed a bill that would do just that, and it is sitting on Gov. Rod Blagojevich's desk awaiting his signature.

ISMS President William E. Kobler, MD, said his organization will redirect its focus and has found a new dragon to slay: the medical liability insurance crisis.

"A significant segment of our membership has been concerned with this," the Rockford-based family physician said of the death penalty-reform bill. "So it's nice to put this one to bed and invest our political energies in other areas."

Most of this political energy will be invested in Washington, D.C., Dr. Kobler said, because he "didn't see" medical liability insurance reform happening in Illinois in the near future.