News in brief - Oct. 4, 2004

Liability crisis forcing patients to change physicians - Liability rates go up in Maryland - Tort reform infomercials under fire - Family medicine residents favor keeping three-year programs - More organ solicitation Web sites developed - JCAHO appoints panel to study cultural issues in hospitals

Liability crisis forcing patients to change physicians

One in four Pennsylvania residents surveyed said their family had been forced to change physicians last year because a doctor was faced with rising medical liability insurance premiums.

Among those surveyed in the IssuesPA/Pew Poll released in September:

16% saw their doctor move his or her practice outside of Pennsylvania.
10% had a physician stop providing certain medical services or treating certain illnesses.
9% had a physician stop practicing medicine.
8% saw a doctor move his or her practice to another part of the state.

Patients in southeastern Pennsylvania were most likely to change physicians, the survey showed. In that region, 31% had to find a new doctor because of medical liability issues. In south central Pennsylvania, 19% of those surveyed were affected.

Liability rates go up in Maryland

Maryland's largest medical liability insurer won't be able to raise rates by the 41% they proposed earlier this year. But the Maryland Insurance Commissioner in September did give Medical Mutual Liability Insurance Society of Maryland and its subsidiary, Professionals Advocate Insurance Co., the go-ahead to raise rates by 33%.

The lower amount was approved after the Maryland State Medical Society requested a hearing on the proposed rate increase. But doctors say it is still a big increase for physicians in a state that the American Medical Association says is showing signs of a medical liability insurance crisis.

"Rate increase proposals filed by medical malpractice insurers have been and will continue to be thoroughly reviewed and analyzed to ensure that both requests for an increase and the amount of the requested increase are supported by actuarial analysis," Maryland Insurance Commissioner Alfred W. Remer Jr. said in a statement.

Tort reform infomercials under fire

Doctors for Medical Liability Reform, a group running infomercials about the need for tort reform in states hardest hit by rising rates, is facing a lawsuit accusing it and three other defendants of invading a woman's privacy by using her image in the commercial without her consent.

Carol Blissitt in September filed a lawsuit in Fulton County (Georgia) Superior Court on behalf of her now deceased mother Sarah Evelyn Blissitt, whose image was in the commercial. The lawsuit also names St. Joseph's Hospital in Atlanta and two groups that were involved in producing and airing the commercials, Mercury Group Inc. and Ackerman McQueen Inc.

The lawsuit alleges that when the family asked why a film crew was in the emergency department where their mother was taken they were told that it was an in-house video to show how the emergency department team related with the emergency technician teams bringing patients to the hospital. The lawsuit also alleges that the family was told that the patients were not being filmed.

The video stopped running on Georgia television stations before the lawsuit was filed. The ad was only scheduled to run for a limited time, said Rob Portman, legal counsel for Doctors for Medical Liability Reform.

Bill Powers, spokesman for Doctors for Medical Liability Reform and executive vice president of Mercury Group, and Portman said they were reviewing the lawsuit and had no comment while it was under review.

"We are taking this lawsuit very seriously, and we will respond as soon as we can and as soon as it is appropriate," Portman said.

Family medicine residents favor keeping three-year programs

A survey of third-year family medicine residents found that 63% still favor a three-year residency program. The remaining 37% supported lengthening the three-year training to four years. The research from the Robert Graham Center: Policy Studies in Family Medicine and Primary Care, was published in the September Journal of the American Board of Family Practice.

A survey on the issue of increasing family medicine residencies to four years was first done in 2000, when first-year residents were surveyed. In a second survey in 2002, the researchers sought out the same group, who were then third-year residents.

Lead author Marguerite Duane, MD, MHA, said family medicine residencies had changed little during the past 35 years and that with the decline in medical student interest in the field, along with advances in medical technology and knowledge, it's time to reconsider how family physicians are trained.

"Given the contemporary concerns about the adequacy of medical education for new models of practice that are needed to enhance care for all Americans, an opportunity for experimentation is at hand," Dr. Duane said. "Our findings indicate that consideration should be given to longer training programs with more emphasis on selected content areas."

More organ solicitation Web sites developed

Todd Krampitz, a Houston man who successfully advertised on billboards and the Internet for a new liver, has gained 10 pounds, and the liver he received Aug. 12 is functioning, his site says.

The site (www.toddneedsaliver.com) also includes links to other personal Web sites of individuals requesting organs. The sites have created concern that others on the organ waiting list will be bypassed in favor of those with the most compelling story or who are more skilled at using the Internet or news media to get their story to the public. Defenders, however, say these stories "put a face" in the public's mind regarding the thousands of people on the organ waiting list and might spur more people to register as organ donors.

JCAHO appoints panel to study cultural issues in hospitals

The Joint Commission on Accreditation of Healthcare Organizations has established a panel of national experts to help study how hospitals are addressing cultural and linguistic issues that impact the quality and safety of patient care.

The 2½-year project, funded by The California Endowment, will explore what hospitals are doing to address the cultural and linguistic needs of patients. Panel members will advise staff on research tools. The effort will culminate with site visits to about 60 hospitals in 2005 to see what hospitals are doing to tackle the issue.

JCAHO will use information from the study to inform health care practitioners and policy-makers about the state of culturally and linguistically appropriate services in hospitals. Study results also will assist the commission in its efforts to reduce disparities in health care.