News in brief - Oct. 24/31, 2005

Cincinnati doctors settle with Blues - Court upholds sanctions on attorney - CMS at work on quality data reporting - Australians win medical Nobel Prize - TV ad targets frivolous lawsuits - AAFP says yes to No Free Lunch - Pipeline of research physicians grows - Ariz. doctor wins family physician award - Minn. medical group installs new president

Cincinnati doctors settle with Blues

Cincinnati-area physicians are poised to see an increase in reimbursement from Anthem Blue Cross and Blue Shield plans in Kentucky and Ohio after both sides agreed to settle a physician lawsuit challenging the insurers' payment practices.

The settlement, which earned preliminary approval in county courts in Ohio and Kentucky, requires the health plans to boost their reimbursement rate by $160 million over three years. It also calls for the insurers to use $2.75 million to create a charitable foundation to promote high-quality health care and help regional physician recruiting, said Donna Gilliam, acting executive director at the Academy of Medicine of Cincinnati.

Doctors in the region filed lawsuits in 2002 against several area insurers. Aetna and Humana settled claims in 2003, and a claim is still proceeding against United HealthCare of Ohio.

The Anthem plans are subsidiaries of WellPoint. Keith Faller, president and CEO of WellPoint's central region, said the settlement "is in the best interest of everyone, including physicians and our members, and builds on our close relationships with physicians."

Court upholds sanctions on attorney

An Ohio appellate court in September upheld a trial court ruling that an attorney should be sanctioned for introducing a frivolous lawsuit.

In a 3-0 decision, the Ohio Court of Appeals Fifth Appellate District in Stark County said the trial court had the jurisdiction to address the motion seeking sanctions, and it correctly imposed them on one attorney.

The case relates to a medical liability lawsuit filed against several Ohio physicians, including gastroenterologist Zev Randy Maycon, MD. A medical expert for the plaintiff did not criticize Dr. Maycon's care. But the plaintiff's attorney, Catherine C. Little, refused to drop Dr. Maycon from the lawsuit, according to the physician's claim against her.

A judge ordered Little to pay Dr. Maycon $6,000, representing the time Dr. Maycon spent preparing for and attending depositions as well as his time preparing for trial. Although Little argued that medical expert testimony was not required to retain Dr. Maycon as a defendant, the appellate court ruled that the physician's role in the case was "not within the common knowledge of jurors," making medical expert witness testimony necessary.

CMS at work on quality data reporting

Centers for Medicare & Medicaid Services Administrator Mark McClellan, MD, said at a House hearing in September that the agency is already at work setting up the infrastructure to allow physicians to report quality data, even though pay-for-performance legislation has not yet been enacted.

McClellan told the House Ways and Means Committee that CMS has 66 quality performance measures for 29 specialties, representing about 80% of Medicare spending. Not all of these measures have gone through the required voluntary consensus standards-setting process -- 36 for primary and outpatient-care physicians have gone through the process -- but McClellan said they are "still of great value."

Australians win medical Nobel Prize

Two Australians won the 2005 Nobel Prize in Physiology or Medicine this month for discovering a bacterium that causes ulcers and stomach inflammation. They are Dr. Barry J. Marshall, a gastroenterologist from the University of Western Australia, and Dr. J. Robin Warren, who was a pathologist at Royal Perth Hospital.

Drs. Marshall and Warren found that Helicobacter pylori was present in almost all patients with gastric inflammation, duodenal ulcer or gastric ulcer, the Nobel committee said. The doctors showed that patients could be cured of peptic ulcer disease by eradicating the bacteria from the stomach.

In 1982, when the two men discovered the bacterium, stress and lifestyle were considered the major causes of peptic ulcer disease. Now it is established that Helicobacter pylori causes more than 90% of duodenal ulcers and up to 80% of gastric ulcers, the committee said.

TV ad targets frivolous lawsuits

The grassroots group Citizens Against Lawsuit Abuse, which runs a Web site (www.sickoflawsuits.org), has launched a national television ad campaign targeting frivolous suits.

The group, which has more than 165,000 physicians, business owners and citizens in chapters across eight states, began the ads as part of Lawsuit Abuse Awareness Week Oct. 3-7.

"Some personal injury lawyers, who file frivolous lawsuits in hopes of striking it rich, are bankrupting our health care system, and we are all paying the price," said Evelyn Tobias-Merrill, MD, the group spokeswoman.

The group also recently conducted a survey of 800 likely voters, of which 79% said they worried that frivolous lawsuits would endanger their efforts to get affordable health care.

AAFP says yes to No Free Lunch

The American Assn. of Family Physicians reversed its decision to ban the anti-pharmaceutical-freebie group No Free Lunch from its annual meeting's exhibit hall in September. At first, the AAFP refused to rent an exhibit slot to the group, which urges physicians to refuse free promotional items and meals from drug makers. The AAFP wrote in a letter that the group's purpose was inconsistent with the purpose of the exhibit hall.

That decision prompted such a strong response that the group changed its mind and allowed No Free Lunch the space to speak with physicians.

The American College of Physicians denied the advocacy group composed of physicians and nurses a space at its annual meeting's exhibit hall in April.

Pipeline of research physicians grows

The number of physicians pursuing research careers appears to be benefiting from increased medical student interest and greater funding from loan repayment programs, according to a study in the September Academic Medicine.

While much has been said about a general shortage of physicians and a trend away from primary care, there also is concern that the physician-scientist population has shrunk in size and grown older during the past 25 years. It has raised concerns about the future of medical research with a clinical emphasis.

In response, a number of initiatives were launched between 1998 and 2002. Efforts include a National Institutes of Health new career award for young physicians doing clinical research, private foundation-funded awards for young and established physician-scientists, and medical school programs that encourage students to participate in research while working toward medical degrees.

The authors said it's unclear if the physician-scientist population is being adequately replenished, but it is clear that the field is heading in the right direction. A larger fraction of medical students are indicating a serious interest in research careers, more first-time NIH grant applicants are being seen and the number of MD-PhDs being funded for research is on the upswing, suggesting that these doctors are able to sustain research careers, according to the study.

Ariz. doctor wins family physician award

Adele O'Sullivan, MD, was named 2006 Family Physician of the Year during the American Academy of Family Physicians' recent annual scientific assembly. The award honors an outstanding family physician who provides patients with compassionate and comprehensive care and serves as a role model to the community, other health professionals, residents and medical students.

Dr. O'Sullivan has committed her life to providing medical care to Arizona's underserved populations, especially the homeless. She has spent the past nine years as medical director of the Maricopa County Health Care for the Homeless Program.

She also is a mentor and a teacher, serving as a clinical lecturer at the University of Arizona College of Medicine, Dept. of Family and Community Medicine, and providing a unique rotation for medical residents and students on the health care needs of the homeless and underserved.

Ten other physicians also were recognized at the AAFP meeting, including Barbara Starfield, MD, MPH, of Baltimore, who won the John G. Walsh Award for Lifetime Contributions to Family Medicine for her leadership in advancing the development of family medicine, and John L. Pfenninger, MD, of Midland, Mich., who received the Thomas W. Johnson Award for his contributions to family medicine education.

Minn. medical group installs new president

Cloquet, Minn., family physician David D. Luehr, MD, recently was inaugurated as the new president of the Minnesota Medical Assn. during the group's annual meeting in Minneapolis. As president, Dr. Luehr will serve the next year as a spokesperson for the association and participate in setting policy.

He practices at the Raiter Clinic in Cloquet and is an associate professor at the University of Minnesota Duluth Medical School. He also serves on the board of directors and the executive committee of Northstar Physicians. He has been active on the executive committee of the Cloquet Community Memorial Hospital, where he has served as chief of staff.

Dr. Luehr has served the MMA in a variety of roles, including vice president and member of the Committee on Practice and Planning.