News in brief - Aug. 16, 2004

Report ups medical error death toll - Florida tracks physician CME online - Former AMA president working on new IOM project - Minn. court rules in genetic case - Alliance of Specialty Medicine gives honors

Report ups medical error death toll

A recent study of Medicare patients by Health Grades Inc., a Colorado-based health care quality consultant, reported that some 195,000 deaths in the United States are attributable to in-hospital medical errors.

The AMA, which disputes the accuracy of the Institute of Medicine's estimate that 44,000 to 98,000 die as a result of medical errors, took issue with the Health Grades study, but noted that working to pass the federal Patient Safety and Quality Improvement Act was a priority of the Association.

In a statement, AMA Immediate Past President Donald J. Palmisano, MD, said: "The AMA strongly supports research that improves patient safety, but a recent report from the for-profit company Health Grades was not peer reviewed, and the authors themselves recognize the flaws in their methodology, which relies on claims data that have inherent limitations, including not being able to explain complex situations or make cause-and-effect connections."

Samantha Collier, MD, Health Grades' vice president of medical affairs, said the company chose to self-publish the study to get the information out to the public more quickly. She said the release also was timed to coincide with the announcement of its Distinguished Hospital Award for Patient Safety to have a balance of positive and negative news.

Florida tracks physician CME online

Florida's Dept. of Health now has the ability to electronically track physicians' CME credits for relicensure.

Half of the physicians licensed in Florida must renew their license before Jan. 31, 2005. CE Broker, which maintains continuing education records for Florida's physicians, partnered with Medical Directions to allow physicians to take online continuing medical education courses from a number of providers and automatically transfer those credits to the state tracking service.

Medical Directions says this is the first statewide system for sending online CME data directly to a physician's licensure records. John Harris Jr., MD, the president of Medical Directions, said this was a big step for online CME.

Florida requires physicians to complete 40 hours of AMA Physicians Recognition Award category 1 CME credits during their two- or three-year licensure term. The 40 hours must include one hour on HIV/AIDS, one hour on domestic violence and two hours on prevention/reducing medical errors.

Former AMA president working on new IOM project

Former AMA President Alan R. Nelson, MD, who previously chaired an Institute of Medicine committee looking into health care disparities, has begun work on a new IOM panel looking into health insurance benefits, payment and performance improvement programs.

The BPPI panel, which held its first of nine scheduled meetings Aug. 3-4, was born out the Medicare Modernization Act and is expected to produce a report in three years.

"There is a lot of movement in a lot of areas to reward quality in terms of payment," Dr. Nelson said. "Of course, that's logical, because one could say it does not make sense to pay a physician the same if they don't follow practice guidelines.

"There are pressures from a whole host of sources to improve quality of care, and payment processes should not be totally divorced from that," he added. "The important thing is to make sure that the processes make sense with risk adjustments for severity of illness."

Dr. Nelson said it's likely incentive-based systems rather than punishment-based systems will be endorsed and that the panel's recommendations will receive close scrutiny from Congress.

"They will be seriously considered by Congress, as Congress asked for this study," he said.

Minn. court rules in genetic case

The Minnesota Supreme Court recently ruled that physicians have a legal duty to inform the parents of a child they are treating about the genetic implications of a child's genetic disorder.

Kimberly Molloy sued three physicians for medical malpractice, claiming that they were negligent in failing to diagnose a genetic disorder in her child. She also claimed that the negligence caused the couple to conceive another child with the same genetic disorder. Physicians countered that they only had a duty to the first child, the person with whom the physician had a physician-patient relationship. The American Medical Association/State Medical Societies Litigation Center and the Minnesota Medical Assn. filed a friend-of-the-court brief supporting the doctors who were being sued.

In a ruling in late May, the Minnesota Supreme Court said it recognized that it is rare that a physician has a duty to anyone outside of the patient they are treating. But the court said this case is an exception.

"Genetic testing and diagnosis does not affect only the patient," the court wrote. "Both the patient and her family can benefit from accurate testing and diagnosis. And conversely, both the patient and her family can be harmed by negligent testing and diagnosis."

Alliance of Specialty Medicine gives honors

The Alliance of Specialty Medicine honored four members of Congress with the Hugh Williamson Award for Congressional Leadership on July 27 at ceremonies held in conjunction with the Democratic National Convention in Boston.

Award recipients were Sen. Max Baucus (D, Mont.), Sen. Jeff Bingaman (D, N.M.), Rep. Bart Gordon (D, Tenn.), and Rep. Sherrod Brown (D, Ohio). The award is named for Williamson, a Revolutionary War surgeon, signer of the Constitution and member of both the Continental Congress and the first U.S. House of Representatives.

"These members of Congress have shown leadership and foresight in their support of health care issues," said John Barnes, chair of the alliance, a coalition of 14 national medical specialty societies representing more than 220,000 physicians. "Whether by making improvements to our nation's Medicare system that enable doctors to continue to provide services to the patients who need them, or by supporting important medical liability reform legislation that will result in greater fairness for both patients and doctors, these members of Congress are on the front lines of ensuring that Americans have continued access to timely specialty care."