News in brief - May 9, 2005

Quality group invites comment on ambulatory care standards - Family medicine board introduces new certification module - Massachusetts practice environment index paints poor picture - Physician-owned insurer promises no base-rate hike for 2005 - More CME deadlines to watch - Pharmacist's refusal to dispense contraceptives costs him $20,000 - One-third of Americans use alternative medicine

Quality group invites comment on ambulatory care standards

Individual physicians and the general public have until May 16 to comment on the National Quality Forum's draft set of 50 proposed standards for measuring and reporting ambulatory care quality.

Consensus standards would measure doctor performance in prenatal care; disease prevention, screening and immunization; asthma and other respiratory diseases; depression; bone diseases; heart disease; and hypertension. The NQF is a private, nonprofit corporation with 260 member organizations including the American Medical Association.

Comments, marked "Attn: Ambulatory Care Project," should be mailed to NQF offices at 601 13th St., NW, Suite 500 North, Washington, D.C. 20005; or faxed to 202-783-3434.

Family medicine board introduces new certification module

The American Board of Family Medicine has launched Performance in Practice modules as part of the maintenance of certification program for family physicians.

The modules are the board's Web-based, individual quality improvement modules in specific health areas. The first two modules center on quality improvement in hypertension and diabetes care. The modules can be completed anytime during the certification process, but once started, they should be finished within six months.

Massachusetts practice environment index paints poor picture

The Massachusetts Medical Society's recently released Physician Practice Environment Index for 2004 showed that the practice environment for the state's physicians dropped for the 11th straight year.

The index is a statistical indicator of nine factors that shape the overall environment in which physicians provide patient care in Massachusetts. For example, medical liability insurance costs and hours per week spent in patient care are considered. The index dropped 1.8% for 2004.

The U.S. Physician Practice Environment, a companion index that the MMS compiles to reflect the national practice environment, also fell at a rate of 2.3%. That's the ninth consecutive drop for the national figure.

"The bad news is that it just keeps dropping," MMS President Alan C. Woodward, MD, said in a statement. "But the sad irony is that in a state known throughout the world for its quality of medical care, physicians in Massachusetts continue to work in a practice environment that's worse than the rest of the nation."

Dr. Woodward said the state and national declines had been fueled by the same factor: sharp increases in the cost of medical liability insurance. Medical liability reform is a top advocacy priority of the MMS as well as the American Medical Association.

Physician-owned insurer promises no base-rate hike for 2005

Physician-owned ISMIE Mutual Insurance Co., which provides liability insurance to more than 13,000 Illinois physicians, announced last month it would not raise base premium rates for 2005. The company raised base rates 35.2% in 2003 and an average 7.4% in 2004.

Company officials cautioned that the decision to not increase base rates in 2005 was not necessarily the start of a trend. But ISMIE Mutual did see a 4% reduction in the number of claims reported per 100 policyholders last year.

ISMIE Mutual and the Illinois State Medical Society are lobbying for comprehensive tort reform in the state, including a $250,000 cap on noneconomic damages. Illinois is one of 20 states the American Medical Association lists as being in crisis because of medical liability premium costs.

More CME deadlines to watch

Continuing medical education professionals seeking accreditation for the first time on or after November 2005 must be in compliance with all of the Accreditation Council for Continuing Medical Education's updated standards for commercial support. To help providers accomplish these tasks, the ACCME has posted forms for a documentation review, an activity review and a surveyor's report on its Web site http:www.accme.org/.

Medical professionals whom the ACCME already has accredited, but who are seeking reaccreditation on or after November 2006, also will have to have all their documentation and procedures compliant with the updated standards. The ACCME revised its standards for commercial support last fall, and the standards became effective May 1 for all new CME activity development.

Pharmacist's refusal to dispense contraceptives costs him $20,000

The Wisconsin Pharmacy Examining board ordered Neil Noesen to pay $20,000 in legal and administrative costs and take six hours of continuing education in pharmacy practice and ethics as a consequence of refusing to fill a woman's contraceptive prescription at a Menomonie, Wis., Kmart in July 2002 and then refusing to transfer the prescription to another pharmacy.

At a state Dept. of Regulation and Licensing hearing held October 2004, the Milwaukee Journal Sentinel reported that Noesen said he refused to fill the prescription because he did not want to commit a sin against his Catholic religious beliefs.

At the pharmacy board's April 13 hearing, Green Bay pharmacist and board Chair Michael Bettiga told Noesen "You can exercise your belief, but you have to make sure there is continuance of care."

One-third of Americans use alternative medicine

In its most recent report on complementary and alternative medicine, the Institute of Medicine says its use is widespread among the U.S. population, with more than one-third of adults reporting that they have used treatments such as herbal remedies, acupuncture and naturopathy.

Despite the popularity, fewer than 40% of complementary and alternative medicine users tell their physicians about it, said the IOM report, "Complementary and Alternative Medicine in the United States." More than half of physicians reported that they would encourage patients to talk to them about using alternative medicine therapies. Doctors also said they would refer patients for treatments that fall into that category.