News in brief - Aug. 2, 2004

Study highlights value of tort reforms - AMA Foundation picks new president - Pa. physicians dissatisfied - Sleep medicine subspecialty OK'd - Maine to monitor prescriptions - Nurses working overtime make more errors - U.S. citizens studying medicine in Cuba get reprieve - Presumed organ donor consent bombs in Britain

Study highlights value of tort reforms

Awards in medical malpractice lawsuits are cut 30%, thanks to California tort reform that caps noneconomic damages at $250,000, according to a new study by Rand Corp., a nonprofit research organization.

Because California's law also limits how much attorneys are allowed to collect, plaintiffs are receiving only 15% less than they would without the California Medical Injury Compensation Reform Act. Lawyers, though, are collecting 60% less than they did before MICRA. California's tort reform was passed in 1975 as an answer to a medical liability insurance problem.

The Rand Institute for Civil Justice analyzed 257 California cases in which the plaintiff won. The trials took place between 1995 and 1999.

"While MICRA's impact on claims that do not reach trial is difficult to measure, the law has had a direct and observable role in about half the malpractice cases where there is a verdict for the plaintiffs," lead researcher Nicholas M. Pace said in a statement. "For defendants, for plaintiffs and for attorneys, MICRA has clearly changed the playing field upon which malpractice claims are litigated in California."

California juries make awards, and judges later adjust them to comply with MICRA. The study, "Capping Noneconomic Awards in Medical Malpractice Trials: California Jury Verdicts Under MICRA," found that:

58% of verdicts in death cases were later capped.
41% of verdicts in injury cases were later capped.
71% of plaintiffs younger than 1 year had verdicts capped.

AMA Foundation picks new president

Krishna Sawhney, MD, a general vascular surgeon in Detroit, has been named president of the American Medical Association Foundation.

Dr. Sawhney was the group's vice president last year, and will serve as president until June 2005. The AMA Foundation supports programs designed to improve the health care of all Americans and provides scholarships for medical students, grants for research and community-based programs and educational resources on issues such as health literacy.

Dr. Sawhney is on the staff of Henry Ford Wyandotte Hospital, and serves as chief of surgery, Downriver region, for the Henry Ford Health System in Detroit. He also is a clinical associate professor of surgery at Wayne State University School of Medicine. He has served as regent and chair of the International Board of Regents at the International College of Surgeons, and was a member of the Board of Governors for the American College of Surgeons. He has held leadership positions for the Wayne County Medical Society and the Michigan State Medical Society.

Pa. physicians dissatisfied

Nearly 40% of more than 800 Pennsylvania high-risk physician specialists surveyed said they were dissatisfied with the practice of medicine, according to a new study from the Pew Charitable Trusts Project on Medical Liability in Pennsylvania.

Among the specialists who took part in the study, "Caring for Patients in a Malpractice Crisis: Physician Satisfaction and Quality of Care":

70% said they would be very or somewhat likely to recommend their specialty to a medical school graduate, but only 15% would recommend practicing in Pennsylvania.
40% said liability insurance premiums were an "extreme burden," and 40% described them as a "major burden." Only 2% said rates were "not at all a burden."
75% agreed with the statement that "because of concerns about malpractice liability, I view every patient as a potential malpractice lawsuit."
91% said the current malpractice system limits physicians' ability to give the highest-quality medical care.

Sleep medicine subspecialty OK'd

The Accreditation Council for Graduate Medical Education approved sleep medicine as a subspecialty for resident training. Residency program guidelines for the multidisciplinary subspecialty are being finalized, and ACGME expects to begin accrediting sleep medicine programs in July 2005.

Maine to monitor prescriptions

With the help of a $300,000 federal grant and a compromise with the state medical association, a prescription-monitoring program was approved by the Maine Legislature.

"We originally opposed the bill three years ago, but we worked on it and worked on it, and the final version we did support," said Maine Medical Assn. Executive Vice President Gordon Smith, adding that the association fiercely opposed efforts to fund the program by adding a state fee to doctors' federal Drug Enforcement Administration licenses.

He also said that physicians will be involved in writing program protocols to ensure that prescriptions written for the proper treatment of pain will not result in doctors being investigated by law enforcement.

Nurses working overtime make more errors

The nursing shortage has decreased patient safety, according to a recent study in Health Affairs. As hospitals cope with the shortage of registered nurses, more nurses are working shifts of more than 12 hours and weeks of more than 40 hours, with the number of patient errors made rising alongside this overtime.

Data collected on 5,317 shifts showed that hospital staff nurses worked longer than scheduled on a daily basis and often worked more than 40 hours per week.

The likelihood of making an error increased with the longer work hours and was three times higher when nurses worked shifts lasting 12.5 hours or more. Working overtime increased the odds of making at least one error, regardless of how long the shift was originally scheduled to be. Working more than 40 hours per week and more than 50 hours per week significantly increased the risk of making an error, as well. More than half the errors and near errors involved medication administration.

U.S. citizens studying medicine in Cuba get reprieve

Secretary of State Colin Powell stepped in to modify travel restrictions to Cuba for the small group of U.S. medical students there.

Some 80 U.S. citizens are studying medicine in Cuba, under a program that provides underprivileged students from around the world the opportunity to study there for free. Tighter U.S. travel restrictions to the island nation were about to make travel between the United States and Cuba extremely difficult for the group from the United States.

The new law would have eliminated their ability to travel to and from Cuba through a program fully funded by the government there. However, Powell stepped in and modified the law, allowing the U.S. students to continue to travel between the two countries.

Presumed organ donor consent bombs in Britain

Members of the British Parliament rejected a proposal to implement a system of "presumed consent" organ donation by a vote of 307-60.

Presumed consent is being studied by the AMA. It involves a system in which it's assumed everyone is a willing organ donor unless they have previously registered their desire to opt out of the system.

According to the Texas-based Presumed Consent Foundation, the following countries all use some form of presumed consent: Austria, Belgium, Bulgaria, Czech Republic, Denmark, Finland, France, Greece, Hungary, Italy, Latvia, Luxembourg, Norway, Poland, Portugal, Singapore, Slovak Republic, Slovenia, Spain, Sweden and Switzerland.