News in brief - Dec. 6, 2004

Feds petition Supreme Court to review assisted-suicide case - La. PAs get prescribing rights - HMO class action suit another step closer to trial - Okla. optometrists get OK for scalpel use - Cancer society elects surgeon as new president

Feds petition Supreme Court to review assisted-suicide case

The federal government filed a petition last month requesting that the U.S. Supreme Court review a May 26 appellate court decision which ruled that Attorney General John Ashcroft did not have the authority to revoke the licenses to prescribe controlled substances of physicians who wrote lethal prescriptions allowed by Oregon's Death With Dignity Act.

The petition notes that the federal Controlled Substances Act authorizes the attorney general to revoke the registration of a physician if it's determined that the registration is "inconsistent with public interest." It also states that the appellate court decision subordinates the attorney general's authority regarding permissible uses of controlled substances to the views held by the 50 individual states.

In its decision, a three-judge panel for the U.S. 9th Circuit Court stated that it was not taking a position on assisted suicide itself. Instead, the question was who has the authority to decide what constitutes "legitimate medical practice." The judges ruled that states were the primary regulators of professional conduct, not the U.S. attorney general.

The Death With Dignity Act allows Oregon physicians to write -- but not administer -- lethal prescriptions for terminally ill and mentally competent Oregon adult residents. Between 1998 and 2003, 171 people used the law to hasten their deaths.

The AMA opposes physician-assisted suicide, and its policy states that assisted suicide is "fundamentally incompatible with the physician's role as healer."

La. PAs get prescribing rights

Physician assistants in Louisiana have been granted permission to prescribe medicine by a new state law.

The Physician Supervised Prescriptive Authority Bill was signed into law by Gov. Kathleen Babineaux Blanco in August.

On Sept. 22, the Louisiana Board of Medical Examiners approved the first applications, granting prescriptive authority to more than 100 PAs in the state as of January 2005. Louisiana is the 47th state to allow prescriptive privileges to physician assistants, according to the American Academy of Physician Assistants.

The Louisiana State Medical Society opposed the legislation.

HMO class action suit another step closer to trial

Doctors suing the nation's HMOs don't need to arbitrate their claims against the companies, the 11th U.S. Circuit Court of Appeals ruled in November. The court, upholding a lower court ruling, said arbitration clauses in some physicians' contracts can't be used to force doctors to arbitrate disputes they never agreed to arbitrate.

The managed care companies being sued had argued that the lawsuits against them should not be allowed to go forward as a class action and instead physicians with arbitration agreements in their contracts should have to arbitrate with the companies.

The appellate court decision likely will mean the doctors' lawsuits, which have been combined before one judge, will go ahead on schedule, said Archie Lamb, co-lead counsel of the national class action lawsuit. A trial is scheduled in a federal court in Miami for March 2005.

Physicians and organized medicine filed lawsuits against the largest health plans claiming that the companies, among other things, paid doctors unfairly.

Aetna and CIGNA have reached settlement agreements with the doctors. The November ruling applies to the remaining defendants in the case.

Those defendants are Pacificare Health Systems, Humana, Coventry Health Care, Anthem Health Plans, Prudential Insurance Co. of America, United Healthcare, United Health Group, Human Health Plan and WellPoint Health Networks.

Okla. optometrists get OK for scalpel use

Gov. Brad Henry of Oklahoma has signed into law a regulation allowing optometrists to do procedures requiring a scalpel, despite requests from organized medicine to not do so.

The regulation was actively opposed by the Oklahoma State Medical Assn., the American Medical Association, the American Academy of Ophthalmology and the Oklahoma Osteopathic Assn.

AMA Trustee William A. Hazel Jr., MD, denounced the governor's recent action.

"The safety of Oklahoma's patients has been dealt a blow by Gov. Henry's decision to approve the Oklahoma Board of Examiners in Optometry regulation allowing nonphysicians to perform eye surgery with a scalpel," Dr. Hazel said. "Patient safety is a top priority of the American Medical Association -- and we condemn this action that puts the safety of Oklahoma's patients at risk."

Optometrists are already permitted to do specific laser surgeries in the state.

Bob Palmer, director of state governmental affairs for the American Academy of Ophthalmology said physicians also were concerned that the new regulation would set a precedent nationally. In particular, optometrists licensed in Oklahoma and working within the Veteran's Health Administration system could work anywhere within the VA system and retain the scope of practice permitted under their Oklahoma license.

Cancer society elects surgeon as new president

Chicago surgeon Stephen F. Sener, MD, is the new national president of the American Cancer Society, which announced new officers to its all-volunteer national board of directors on Nov. 13.

Dr. Sener is vice chair of the department of surgery at Evanston Northwestern Healthcare in Illinois and professor of surgery at Northwestern University's Feinberg School of Medicine. He is a graduate of Northwestern University Medical School.

Since 1984, Dr. Sener has been an active volunteer for the society, starting as a member of the Illinois Division's Cancer Incidence and End Results Committee. He was president of the Illinois Division from 1993 to 1994 and has served as the society's representative to the American Joint Committee on Cancer and the Commission on Cancer.