Letters to the Editor - May 9, 2005

New Jersey wrong to blame physicians for health care disparities - Abusive behavior test: Would you say same thing to a subordinate if that person's spouse was present? - When judging physician bullying, consider what would have happened if the aggressor were a nurse - Absolute immunity for peer reviews should be abolished - Medicare cuts ironic from those who lay claim to pro-life, family values

New Jersey wrong to blame physicians for health care disparities

Regarding "Cultural competency now law in New Jersey" (Article, April 25): The recently signed bill in New Jersey requiring physicians to demonstrate "cultural competence" is just another striking example of the current anti-physician political climate.

This bill will require physicians to obtain certification from the state to receive or renew licensure.

Any fee charged for this would be essentially a tax on physicians. At the same time it is a scheme to pander for minority votes.

Physician training is not the cause of disparities in medical care delivery. Ironically, at the same time, the Legislature and acting governor of New Jersey are cutting funding for Medicaid and other state programs that provide assistance to the very same groups that are the "victims" of the alleged inabilities of physicians.

Once again, politicians have managed to create a revenue source while shifting blame for poor outcomes onto the backs of the physician community.

--Steven Nachtigall, MD, Northfield, N.J.

Abusive behavior test: Would you say same thing to a subordinate if that person's spouse was present?

Regarding "Bully case verdict a warning to doctors" (Article, April 18): This article brings much-needed attention to an old problem. Abusive behavior by doctors is behavior that should simply be considered unacceptable, period. The tantrums thrown in hospitals and offices have been tolerated by residents, nurses and other staff for far too long. These acts are indeed bullying, as they are often directed at people who are perceived as being powerless to respond.

The only problem with a situation like the one described in your article is that the lawyers are being used to handle the problem. This is a problem most effectively, and correctly, addressed via the state medical boards and the criminal justice system.

The time has come for physicians to stop tolerating such behavior in their ranks, and for subordinates to know and be able to exercise their rights in circumstances of abusive behavior. Let's keep the "civil justice" (i.e., monetary gain) lawyers out of this problem. To make it simple -- don't say anything to an employee/subordinate that you wouldn't say to them in front of their spouse.

--Paul Berger, MD, Clinton, N.C.

When judging physician bullying, consider what would have happened if the aggressor were a nurse

Regarding "Bully case verdict a warning to doctors" (Article, April 18): As a registered nurse for 30 years, I have expertise in the field of workplace bullies. Several hospitals in this area have new policies regarding inappropriate behavior by physicians and employees.

To date, few of the procedures are carried out by the hospital. The only one I know of required a physician to make a verbal and written apology to a nurse. I would like to make a suggestion regarding deciding if the behavior was a true problem or not. Reverse the situation: What would have happened if the aggressor were a nurse, perfusionist or anyone other than a physician?

--Myra Thomas, RN, Moultrie, Ga.

Absolute immunity for peer reviews should be abolished

Regarding "No absolute immunity for peer reviewers" (Article, March 7): In this era of accountability and transparency, nobody is entitled to absolute immunity. Like absolute power, it will lead to exploitation, cover-up and fraud.

Most of the members of the peer review committee, unless painstakingly picked on a no-conflict-of-interest basis, are in competition with the victim. This should be counter-balanced. Courts are right in denying the absolute immunity.

--Sundar V. Nilavar, MD, Urbana, Ohio

Medicare cuts ironic from those who lay claim to pro-life, family values

Regarding "Medicare trustees: Gloomy forecast for physician reimbursement rates" (Article, April 11): A Medicare payment plan that results in limiting medical care to seniors is a gentle form of extermination. This is an odd position for the family values/pro-life crowd behind this cruel plan.

The whole thing is disgusting. Surely the Republican leadership can find a way to give away public money to private companies without sacrificing good health care for seniors.

--Mitchel Osman, MD, Mt. Pleasant, Mich.