News in brief - July 12, 2004

Physicians express concern over "partial-birth abortion" subpoenas - Medicare and NCI forge alliance - AMA lobbies for patient safety legislation - Washington state doctors file liability reform ballot initiative - D.C. City Council contemplates liability reform - FDA tobacco measure tied to tax bill - Hospital charges to the uninsured to be investigated

Physicians express concern over "partial-birth abortion" subpoenas

Delegates to the AMA's Annual Meeting in June directed the Association to communicate to President Bush and the Dept. of Justice their concern about the government's decision earlier this year to subpoena private medical records of patients who had miscarriages and abortions.

Exactly what form the communication might take was still undecided at press time. The majority of physicians gathered for the meeting said the government went too far in trying to collect information so that it could defend the Partial-Birth Abortion Ban Act against several lawsuits that physicians and women's right groups filed in federal courts.

"We absolutely have to protect individual patients' privacy," said New Jersey general surgeon Michael H. Bernstein, MD.

But not everyone agreed that the government crossed the line. Illinois obstetrician-gynecologist Leroy M. Sprang, MD, said the government went to great lengths to have hospitals remove identifying information before patients' charts were released.

Medicare and NCI forge alliance

The Centers for Medicare & Medicaid Services and the National Cancer Institute have adopted a collaborative approach to bringing new cancer drugs to patients. The effort will aim to increase the amount of information that doctors and patients use to guide decisions about how best to use new technologies.

The initiative will include a joint process for collecting and evaluating clinical evidence, making payment and coverage decisions, and providing resources designed to improve cancer patients' quality of care.

AMA lobbies for patient safety legislation

The American Medical Association is pushing lawmakers to pass patient safety legislation that would create an error reporting system similar to the one used in the aviation industry. The system would allow accidents to be reported quickly and confidentially so that the information could be used to help avoid the same mistakes later.

The House passed the Patient Safety and Quality Improvement Act last year. A Senate committee has passed the legislation, but the full Senate has yet to vote. The AMA ran an advertisement last month in National Journal, Roll Call and Congress Daily titled "Time is Running Out," which urges the Senate to adopt the measure.

"Our current health care system promotes a culture of shame and blame. We need the Senate to act now for our patients' safety," said Donald J. Palmisano, MD, the AMA immediate past president, in announcing the ad campaign. "Physicians, nurses and other health care professionals can't change the culture alone."

Washington state doctors file liability reform ballot initiative

Washington state physicians are trying to force state lawmakers' hand by filing an initiative to put medical liability reform on the ballot in fall 2005 if legislators don't act on the issue before then. The group responsible for the effort, Doctors for Sensible Lawsuit Reform, must gather 197,734 signatures by the end of this year to get the question on the ballot.

Washington is one of 20 states the American Medical Association says is experiencing a medical liability insurance crisis. Doctors believe reforms, such as capping attorney fees and allowing large awards to be paid over time, will help ease the problem.

D.C. City Council contemplates liability reform

The Washington, D.C., City Council is considering a bill that would, among other things, cap noneconomic damages in medical malpractice lawsuits at $250,000, expand the Good Samaritan law to physicians and others who provide free care, and limit attorney contingency fees.

Doctors see the bill as a way to improve the medical liability insurance climate that has caused physicians to give up their practices or to stop performing risky procedures.

"We are headed down a very dark path where access most assuredly will become an issue," Medical Society of the District of Columbia President Peter E. Lavine, MD, said in a statement.

FDA tobacco measure tied to tax bill

Attempts to give the Food and Drug Administration some regulatory control over cigarettes and other tobacco products are being tied to a tobacco buyout amendment in a corporate tax bill moving through Congress.

There are currently stand-alone bills in the House and Senate that would require companies to disclose the ingredients in their cigarettes to the FDA and bar them from calling their products light or ultralight without agency approval. The FDA would also be given the authority to ban some ingredients and require reductions in nicotine levels.

But members of the Senate would like to add those provisions to the corporate tax bill, which has already been passed in the House, to offset the effects of the tobacco buyout provisions, which could lower the price of tobacco products.

Hospital charges to the uninsured to be investigated

The House recently held a series of hearings to assess whether reports regarding the overcharging of uninsured patients indicated that some nonprofit hospitals are not fulfilling their roles in providing charity care.

A congressional investigation showed that the uninsured are charged more than insured patients and that hospitals often had aggressive policies for collecting medical debt. Many poor and uninsured patients are eligible for aid programs, but hospitals often fail to inform them.

The House investigators said that many of these policies have been changed since these reports came out. Hospital executives said they are expected to take on too much free care and it is straining the ability to provide services to their communities.