News in brief - Dec. 4, 2006

Conn. trial lawyers ask state to investigate liability insurance rates - Denver immunization program lauded - Board certification pursued less often - HHS secretary says: Let's all get connected - AMA to lead on work force diversity - AMA finances in black again - AMA says quality group lacks transparency - AMA monitors evolving physician disaster-response systems - Medical students get head start on practice - No smoking ban, no AMA meetings

Conn. trial lawyers ask state to investigate liability insurance rates

The Connecticut Trial Lawyers Assn. is asking state insurance regulators to rein in premiums that Connecticut Medical Insurance Co. charges physicians, saying they are "overly excessive" compared with the company's healthy profits and reserves over the past two years.

The lawyers group, in an October letter, asked the state's insurance commissioner, Susan F. Cogswell, to conduct a "thorough examination" of the insurer's premiums, to ensure that doctors have access to affordable medical liability coverage, and patients have access to care.

Officials of CMIC, owned by doctors and other health professionals, refute the CTLA's analysis and say the lawyers' efforts are aimed at deterring tort reform. (Connecticut does not have a cap on noneconomic damages.)

The company said its rates have stayed at the same level since 2005.

At press time, trial lawyers were scheduled to meet with insurance officials on Nov. 27, said the CTLA's executive director, Neil H. Ferstand.

Denver immunization program lauded

A community health center program that made big strides in its immunization rates was singled out for recognition by the Joint Commission on Accreditation of Healthcare Organizations in November.

Denver Health and Hospital Authority Community Health Services had low immunization rates at its primary care sites and developed a registry to track patients and improve the group's ability to vaccinate children on schedule. Denver Health's immunization rate for 1-year-olds improved 26%, while its rate for 2-year-olds jumped 46%.

The Joint Commission recognized the accomplishment with the Ernest Amory Codman Award in the ambulatory care category for the health center's use of outcomes measurement to improve health care quality.

The Denver Health initiative "proves that process and outcomes measures can be successfully translated into meaningful practices that benefit patients," Joint Commission President Dennis S. O'Leary, MD, said in a statement.

Board certification pursued less often

Board certification appears to have become a less important professional goal. Of 1997 graduating seniors from allopathic medical schools, 97.3% said they planned to become board certified. But this figure dropped to 88.4% in 2004, according to a study in the October supplemental issue of Academic Medicine.

HHS secretary says: Let's all get connected

Health and Human Services Secretary Michael Leavitt used a cell phone to illustrate his vision of a health care system that connects physicians, hospitals, pharmacies and labs and allows them to communicate. "It is our task, our challenge and our obligation ... to reshape the health care sector into a true health care system," he said. Leavitt was the keynote speaker at the American Medical Association's 215th House of Delegates meeting, held in Las Vegas in November.

AMA to lead on work force diversity

The AMA House of Delegates voted to have the Association take the lead in fighting the underrepresentation of women, racial and ethnic minorities, the poor, people with disabilities, and gays, lesbians and transgender individuals in the physician work force.

Specifically, the AMA will work with the Assn. of American Medical Colleges to advocate for more federal, state and private money for pipeline programs, medical school minority affairs offices, financial aid and recruitment programs. Delegates also asked the AMA to lobby to restore federal funding for Title VII programs that recent budget cuts endangered. These programs pay for medical education for racial and ethnic minorities and also target geographically underserved areas. The AMA will report back at its 2009 Annual Meeting on progress in these areas, and also update delegates on the recruitment and retention of physicians to work with underserved populations.

When last measured in 2004, Hispanics totaled only 5% of doctors in the AMA Physician Masterfile, while blacks counted for 3.7% and Native Americans/Alaska Natives tallied fewer than 1% of physicians. According to the Council on Medical Education report the house adopted, 60% of medical students who matriculated between 1987 and 2003 came from the nation's wealthiest families, while 20% came from the bottom two income quintiles. Minority physicians are more likely to practice in underserved areas, the council report said.

AMA finances in black again

The American Medical Association expects $18.5 million in operating profits in 2006, marking the seventh year straight that the Association has posted operating profits.

That trend is expected to continue in 2007, with the AMA expecting a $10.7 million operating profit next year, according to numbers released at the Association's Interim Meeting in November.

This year's expected $18.5 million in operating profits is nearly double the $9.5 million originally forecasted, according to the AMA's 2007 Budget Book. Higher publishing and business service revenue increases and lower variable costs of products sold and selling expenses are expected to account for part of that gain. Membership dues revenues are expected to decrease about 3% in 2006 compared with 2005, which means about $1.5 million less than budgeted. But expenses in that area were $1.8 million less than planned, because not all of the money budgeted for marketing and promotional expenses was spent.

By 2007, dues revenue is projected to increase by 1.7%, and publishing and business services revenues are expected to go up by 2.5%.

AMA says quality group lacks transparency

The AQA Alliance needs to become more transparent and slow down, according to the AMA's House of Delegates. AQA, an influential consensus-building group formed to develop measures for quality reporting and pay for performance, has favored employers and health insurers in its policymaking, delegates said.

At its November Interim Meeting, the house adopted a resolution saying the AQA -- convened in September 2004 by the American Academy of Family Physicians, the American College of Physicians, America's Health Insurance Plans and the Agency for Healthcare Research and Quality -- should "establish a fair and open process for conducting its business through bylaws, due process, representative voting and respect for alternate viewpoints."

The adopted resolution also says AQA should avoid rushing to endorse measures that might harm patient care and conflict with AMA principles and guidelines on pay-for-performance. AQA, formerly known as the Ambulatory Care Quality Alliance, published a starter set of 26 ambulatory care quality measures in May 2005. The set measures appropriate care in areas ranging from breast cancer screening to treatment for children with upper respiratory infections.

AMA monitors evolving physician disaster-response systems

The AMA is involved -- and will continue to be involved -- in monitoring programs that will make it easier for physicians to cross state lines and help out after disasters, says a Board of Trustees report presented and adopted at the Association's Interim Meeting in Las Vegas in November.

The AMA also will continue to support laws and policies such as license reciprocity and civil liability protections that encourage physicians to volunteer during disasters.

For example, the Association, through the Center on Public Health Preparedness and Disaster Response, is watching how programs such as the Emergency System for Advance Registration of Volunteer Health Professionals evolve.

This is a system the Dept. of Health and Human Services Secretary is creating to register doctors who want to volunteer during a public health emergency and verify their credentials, licenses and other information before disasters strike. The AMA also is monitoring volunteer organizations such as the Medical Reserve Corps, a national network of community-based citizen volunteer units.

The awareness and need for these systems comes after volunteer physicians ran into barriers in providing care after the Sept. 11, 2001, attacks. New York City hospital administrators said they couldn't use volunteer physicians because they could not confirm or verify basic licensing or credentialing information, including training, skills, competencies and employment. Similar problems arose after Hurricane Katrina.

Medical students get head start on practice

Medical students, with assistance from physicians from the Nevada State Medical Assn., provided about 200 children at a Las Vegas Head Start facility with well-child exams. The November event kicked off the AMA Medical Student Section's year-long national service project, Covering the Uninsured and Protecting Access to Care. Students performed health screenings and provided information on common pediatric issues such as ear infections, vaccinations and nutritional needs. Expanding coverage for the uninsured and increasing access to care is one of the AMA's top advocacy items.

No smoking ban, no AMA meetings

All future AMA meetings and conferences that have not been contracted will be held in cities and states that have laws requiring smoke-free worksites and public spaces. AMA delegates adopted the policy at their Interim Meeting.

"As a physician organization, we must set an example for our patients. We hope our action today will help convince states, counties and municipalities to adopt legislation protecting the public from the danger of exposure to secondhand smoke," AMA board Chair Cecil B. Wilson, MD, said in a statement.