Letters to the Editor - June 28, 2004

One solution to liability crisis: Go bare everywhere - OSHA offers guidance on avoiding needlestick injury - Heavy-handed medical boards increase defensiveness among physicians

One solution to liability crisis: Go bare everywhere

Regarding "Physicians weigh odds of going bare" (Article, April 5): The presence of liability insurance serves only as an incentive to sue, not to reform a process that serves the plaintiffs' bar quite well. Suing physicians hasn't improved the quality of medical care.

I've long favored the 2x4 approach over diplomacy. The quickest way to bring sanity to the liability insurance crisis is for everyone to go bare.

Hospitals would be forced to allow physicians to continue to admit patients or would all have to close their doors. Insurance companies no longer would be wallowing in our premium dollars and would go out of business.

Likewise, the plaintiffs' bar would not waste time with us if there were no pot of gold and would go back to chasing cigarette and gun manufacturers and the fast-food industry.

Then, after we've gotten everyone's attention, maybe we can all sit down and create a better system that protects patient and physician interests, eliminates unfounded suits and provides affordable insurance.

--David A. Rivera, MD, Lombard, Ill.

OSHA offers guidance on avoiding needlestick injury

Regarding "Campaign targets needlestick injuries" (Article, March 22/29): Your article reports that many health care organizations have failed to comply with the laws regarding prevention of accidental needlesticks. The issue of needlestick injury receives little press and continues to be a significant problem.

We all need to participate in solving this problem by reducing needle exposures and taking advantage of recent technological advances aimed at reducing injury.

The Occupational Safety and Health Administration has newly released a document to improve awareness of this issue and provide alternatives. It is called "Fact Sheet: Securing Medical Catheters," and outlines hazards related to the use of suture needles and tape to secure catheters.

This fact sheet is available on OSHA's Web site (www.osha.gov/SLTC/bloodbornepathogens/factsheet_catheters.html).

It is essential that both clinicians and health care organizations become better informed about new safety technology.

Changing habits is difficult, but there are safer approaches available now that can help to reduce the disturbingly high number of accidental needlesticks that continue to plague us.

This is true even for such seemingly mundane procedures such as inserting and securing a catheter, because these procedures remain a common source of potentially deadly accidental needlesticks.

--Gregory J. Schears, MD, Rochester, Minn.

Heavy-handed medical boards increase defensiveness among physicians

Regarding "More doctors disciplined as states bolster medical boards" (Article, April 26): Your front-page article about increased state board discipline raises very serious concerns that are unappreciated by nonphysicians.

State medical boards often are just another complex anti-physician entity.

The article might give the impression that speeding to discipline is good, but this means that physicians have to promptly put their families on hold to deal with nuisance complaints and spend thousands of dollars for counsel.

Impaired physicians who truly endanger patient health occasionally exist. Impairment includes neither poorly spelled notes nor off-label dosing and prescribing. Increased funding of the current system of state medical boards does not improve medicine -- it merely increases the perception of state board aggression.

The result? Increased physician defensiveness and the abandonment of difficult patients needing complex care.

It results in a shift in patient care priorities, from connecting personally with patients to keeping utterly meticulous notes. This confuses business accounting with the intimacy of and art of medicine.

--James Schaller, MD, Naples, Fla.