News in brief - Feb. 6, 2006

Miss. court rules that some medical liability reforms are constitutional - Neurologists update expert witness guidelines - Grant awarded to develop communication training for physicians - N.Y. overall physician supply on rise - Small patient sample can show how a physician interacts with patients - New leader for osteopathic schools

Miss. court rules that some medical liability reforms are constitutional

Mississippi doctors in January received a favorable court ruling on a constitutional challenge to some of the state's recent tort reforms.

Hinds County Circuit Judge Swan Yerger upheld amendments to state law that require plaintiffs to give a 60-day notice to doctors before filing a medical liability lawsuit and one that says doctors are financially responsible for only their portion of fault in case. The amendments were passed in 2004 as part of a medical liability reform package that established a $500,000 cap on noneconomic damages.

The plaintiffs in the lawsuit alleged that the amendments to the statutes were unconstitutional. The ruling was issued in the judge's order that dismissed some of the plaintiff's case against the defendant. At press time the plaintiffs had not decided whether they would appeal the ruling.

Neurologists update expert witness guidelines

The American Academy of Neurology updated its 16-year-old expert witness testimony guidelines calling for tougher credentials and advising physicians to remain impartial.

The revised version includes a new section that defines elements of medical expert testimony, such as evaluating medical records and formulating an opinion, "to assist the court in understanding medical evidence."

As before, the qualifications affirm that experts must have a valid license to practice and require the expert to specialize in the area relevant to the case. But if a doctor is not practicing, the guidelines added that the expert must have relevant publication or teaching experience within three to five years of providing testimony.

The revised version also revamped guidelines to ensure that compensation and testimony are not tied to the outcome of the litigation. With regard to conduct, the new guidelines restate that "it is unethical for a medical expert to tie the level of compensation in a particular case to the outcome of that case." But the AAN added that medical expert witnesses who violate the rules of conduct are subject to peer review.

After increasing complaints from peers against other neurologists who provided expert witness testimony, the AAN decided the revision was overdue. The purpose of the new guidelines is "to promote expert testimony that is competent and grounded in science." The new guidelines took effect Jan. 10.

Grant awarded to develop communication training for physicians

Joint Commission Resources received a grant from the Robert Wood Johnson Foundation to develop a training series to help physicians and other practitioners improve patient safety through better communication.

The JCR project will develop educational materials for physicians, nurses and other clinical professionals to encourage effective communication within their disciplines and across professions. The training series will include presentation materials, trainer guidelines, group- and individual-participant materials and video scenarios about patient safety.

The series is expected to be available in the fall of 2007. It will be used in hospitals and will include a Web site featuring a bulletin-board system and downloadable resources. The Joint Commission Sentinel Event database shows that communication is cited as a root cause in nearly 70% of reported sentinel events.

Illinois-based JCR is a nonprofit affiliate of the Joint Commission on Accreditation of Healthcare Organizations.

N.Y. overall physician supply on rise

New research from the New York Center for Health Workforce Studies shows that the state experienced an increase in its physician supply between 2000 and 2004, with the total number of licensed physicians topping 70,000 in 2004. But some regions in upstate New York saw a decline in primary care physicians and ob-gyns. More than 70% of the state's physicians were white, while 10% were underrepresented minorities.

Primary care comprised 30% of New York's physician work force. International medical graduates represented 35% of the state's practicing physicians.

Small patient sample can show how a physician interacts with patients

It takes about 45 patients to determine how well a physician rates on measures used to determine communication quality, accessibility and coordination of care, according to a study published in the January Journal of General Internal Medicine.

"These findings reveal that among a modest-size sample of a physician's patients, it is possible to obtain a snapshot of what it is like to be a patient of that physician that appears to hold true from patient to patient," said lead study author Dana Gelb Safran, ScD, director of the Health Institute at Tufts-New England Medical Center in Boston.

The study surveyed 13,000 Massachusetts adult patients of 215 general practice physicians at 67 practices. On average, the researchers received 58 surveys per physician included in the study. Average performance scores varied more by individual physician and practice group than by health system, according to the study. The participating physicians were culled from the state's Medicaid program and five health plans.

New leader for osteopathic schools

The American Assn. of Colleges of Osteopathic Medicine named Stephen C. Shannon, DO, MPH, the organization's new president and chief executive officer as of Jan. 23.

He comes from the University of New England College of Osteopathic Medicine in Biddeford, Maine, where he has served as dean and vice president for health services since 1995.

"I am very honored to have been chosen for this position," Dr. Shannon said in a statement. "[AACOM] and its staff have a tremendous potential to lead osteopathic medical education, and to have a significant impact on health professions education and the future of health care in the United States."

At the University of New England, Dr. Shannon oversaw the education of 500 medical school students and residents. He also was responsible for the biomedical and clinical faculty's research activities and the university faculty's clinical services. Dr. Shannon chaired the AACOM board of deans from July 2003 to June 2005. He is board certified in family medicine and preventive medicine.

Dr. Shannon succeeds Douglas L. Wood, DO, PhD. Dr. Wood, who led the AACOM for 10 years, is leaving to become the founding dean of a branch campus that A.T. Still University of Health Sciences Kirksville College of Osteopathic Medicine in Missouri is establishing in Mesa, Ariz.