News in brief - Feb. 9, 2004

Study says caps lower premiums - Pa. to keep malpractice case count - Medical school honors female scientist - Med students weak on clinical skills - Arizona computer registry for end-of-life choices proposed - U.K. ignores physicians' call for presumed consent organ donation - More states added to credentialing process - Medical society and foundation announce grants

Study says caps lower premiums

Physicians in states with caps on medical malpractice awards enjoy premiums that are 17.1% lower than those in states without caps, according to a new study from the chair of the health policy and management department at Emory University Rollins School of Public Health in Atlanta.

Author Kenneth E. Thorpe said caps at the federal level ultimately would mean lower insurance premiums, but he questioned whether that would accomplish the liability system goals. "The results suggest that capping awards may improve the profitability of malpractice carriers and reduce premiums," Thorpe said in the study. "Whether this is socially desirable or improves the goals of deterrence and compensation remains an open question."

The report, "The Medical Malpractice 'Crisis': Recent Trends And The Impact Of State Tort Reforms," is available online (content.healthaffairs.org/cgi/content/full/hlthaff.w4.20v1/DC1).

Pa. to keep malpractice case count

The Administrative Office of Pennsylvania Courts has asked local courthouse officials to tally up how many medical malpractice cases were filed in the past four years and to report new cases as they are filed.

The state plans to use the data to help determine how medical malpractice lawsuits play into the medical liability insurance problems physicians are experiencing. Pennsylvania is one of 19 states that the AMA says is in the middle of an insurance crisis that has physicians retiring early, discontinuing high-risk services or relocating to other states because they cannot afford insurance or cannot find a carrier who will insure them.

Physicians say frivolous lawsuits and outrageous jury awards are to blame. Trial attorneys say reform needs to be focused on reducing medical errors.

Medical school honors female scientist

Women have surpassed men in terms of the number applying to medical school, but until now they didn't have a medical school named after one of them. The Chicago Medical School at the Finch University of Health Sciences says it is the first to honor a female scientist in such a manner.

The Finch University/Chicago Medical School is now the Rosalind Franklin University of Medicine and Science in honor of the woman who helped discover the structure of DNA.

Med students weak on clinical skills

Many medical students are inadequately prepared for their clinical rotations, according to "Faculty and the Observation of Trainees' Clinical Skills: Problems and Opportunities" published in the January Academic Medicine.

They lack solid interviewing and physical exam skills, according to author Eric Holmboe, MD. Increased training on standardized patients is helpful, the article said, but nothing replaces working with real patients under direct faculty observation.

"Faculty are in the best position to document improvement over time and to certify trainees have attained sophisticated levels of skill in medical interviewing, physical examination and counseling. Unfortunately, current evidence suggests significant deficiencies in faculty direct observation evaluation skills," Dr. Holmboe said in his article.

Arizona computer registry for end-of-life choices proposed

Arizona state Rep. Deb Gullett has proposed creating a computer registry on which people could record their preferences for end-of-life care. Those preferences then would be available to health care professionals as they take care of patients with life-threatening conditions, the Tucson Citizen reported.

Her proposal calls for issuing wallet-sized cards to participants containing a file number and password that would be needed to retrieve information from the database. The registry would be maintained by the Arizona Secretary of State's office.

U.K. ignores physicians' call for presumed consent organ donation

Despite a plea from the British Medical Assn., provisions for allowing a "presumed consent" organ donation policy were not added to the Human Tissues Bill now before the United Kingdom House of Commons.

Under presumed-consent policies, organs can be removed from suitable donors without permission unless the patients previously had registered their objections to being an organ donor. Dr. Michael Wilks, chair of the BMA Ethics Committee, called the decision to not pursue presumed consent "wasting an opportunity."

"The BMA supports a 'soft' system of presumed consent in which relatives' views are also taken into account," he said in a press release. "The crucial difference would be in the approach to relatives. Instead of being asked to consent to donation, they would be informed that their relative had not opted out of donation."

The donation would proceed unless the relatives said they knew the patient wouldn't want to donate or if the donation would cause the family "major distress," Dr. Wilks said.

Spain, which has the highest organ donation rates in the world, has a presumed-consent policy, but U.K. Health Minister Rosie Winterton said other policies contribute to that success.

"Evidence from Spain ... has shown that having a person responsible for identifying possible organ donors in the hospital is the most effective way of increasing donors," Winterton said in a press release.

More states added to credentialing process

The Council for Affordable Quality Healthcare recently launched its Universal Credentialing DataSource system in five more states: Idaho, Montana, North Dakota, South Dakota and Wyoming.

The nonprofit alliance of health plans and networks developed the system to help physicians more easily and cost-effectively provide required credentialing information to health care organizations. The Web-based system allows doctors to submit their credentials in a single application to meet the credentialing needs of health care organizations taking part in the program.

The free service to doctors keeps physicians from having to submit to the cumbersome credentialing process every two to three years with individual health plans. Physicians authorize access to participating organizations, which review and verify credentialing data and decide if a physician meets standards for participation.

CAQH, created in 1999 and based in Washington, D.C., launched the credentialing system in Colorado and Virginia in March 2002. The system now has 37 states and Washington, D.C., and is expected to include every state this year.

Medical society and foundation announce grants

The Massachusetts Medical Society and Alliance Charitable Foundation awarded two grants totaling $50,000 to help provide health care to the homeless, low-income and uninsured in Boston and the surrounding area.

Women of Means, a Wellesley-based nonprofit agency that provides free health care to homeless or marginally housed women in Boston, received $20,000. The Free Health Care Center Fund in the southern Berkshire County community of Sheffield, Mass., was awarded $30,000.

Women of Means was established in 1998 by Roseanna H. Means, MD, to improve the lives of women who are homeless or marginally housed through quality health care, education and advocacy. The agency also trains and educates health care professionals on how to identify and treat homeless persons.

The Free Health Care Center Fund's purpose is to establish Volunteers in Medicine Berkshires, a free clinic to provide medical, dental and mental health services to the income-qualified uninsured of the southern Berkshire region.