News in brief - Jan. 1/8, 2007

State report: Florida sees liability insurance market improvements - Foundation out of Aetna settlement awards $5.6 million in grants - ACGME director set to retire - Conflicts of interest in clinical trials don't worry cancer patients - Calif. medical school proposal moves forward

State report: Florida sees liability insurance market improvements

Florida's medical liability insurance market is looking up as a result of 2003 tort reform measures, according to a 2006 Florida Office of Insurance Regulation report.

Since legislators passed a $500,000 cap on noneconomic damages in medical liability cases, rate hikes have subsided, the November 2006 analysis indicated. The average rate increase in 2005 was 8%, down significantly from 28.6% in 2004, the report said.

Competition also has improved, with 15 insurance companies comprising 80% of the medical liability market in 2005. That's up from 12 in 2004.

Foundation out of Aetna settlement awards $5.6 million in grants

The Physicians' Foundation for Health Systems Excellence last month announced more than $5.6 million in grants to 15 applicants as part of its 2006 Excellence in Practice program.

Awards range from $100,000 to nearly $500,000 over three years and are going to groups focusing on quality issues such as medical error disclosure to patients, chronic care for arthritis patients, medical disaster response, electronic prescribing, health information technology adoption and racial disparities in diabetes care.

The foundation has assets of $98 million derived from the 2003 class-action lawsuit settlement between doctors, 19 state medical societies and Aetna Inc. The foundation received more than 200 applications for the 2006 grants; a first round of grants was awarded last year.

"Medical practice as we know it is under stress," Tim Norbeck, the foundation's executive director, said in a statement. "The foundation's grants work toward helping practicing physicians meet some of these contemporary realities while delivering safe, effective medical care."

The largest grant, $462,310 over three years, went to the New York Chapter of the American College of Physicians for a training program to help primary care physicians develop "mindfulness" and "narrative reflection" skills to reduce stress. The program will measure the changes' impact on doctors' satisfaction levels.

ACGME director set to retire

David C. Leach, MD, the Accreditation Council for Graduate Medical Education's executive director for a decade, will retire in September.

During Dr. Leach's tenure, the agency adopted duty-hour limits for residents, moved to an outcomes-based evaluation for programs and transitioned to computerized data collection.

Dr. Leach, a board-certified internist and endocrinologist, came to the ACGME from the Henry Ford Health System in Detroit, where he was director of medical education. He also was an assistant dean for the University of Michigan Medical School in Ann Arbor. No details were available on a search for a new ACGME executive director.

Conflicts of interest in clinical trials don't worry cancer patients

While clinical researchers have been heavily scrutinized for conflicts of interest that many fear compromise the integrity of study outcomes, patients do not seem that concerned, according to 253 in-person interviews with patients at five U.S. medical centers. Eighty percent of cancer patients enrolled in clinical trials said they were "not worried at all" about researchers' conflicts of interests. About 75% said that they still would have participated had they known about a conflict.

The Nov. 30, 2006 New England Journal of Medicine study found that patients were not worried about physician researchers who received consulting or speaking fees, owned stock, or received royalty payments from the pharmaceutical company whose drug was being investigated. A minority, 40%, said financial ties should be disclosed to patients; 40% said researchers should disclose how they monitor potential conflicts; 17% said no disclosure was needed.

Authors of the study, funded by the National Institutes of Health, said it is unclear why patients appear to be so sanguine about financial conflicts, but speculated that "patients may feel that some types of ties, such as consulting, are necessary to facilitate the conduct of research and to make progress against diseases." They also said that patients in noncancer trials might be more concerned about financial conflicts.

Calif. medical school proposal moves forward

The University of California at Riverside is taking the next step toward building a four-year medical school on campus. With approval from the University of California's governing board, UC Riverside began a national search for a dean. School officials expect to open the medical school in fall 2012.

Total projected operating costs for the medical school between 2007 and 2022 is $860 million. Total capital costs for the same 15-year period are estimated at $496 million. The university plans renovations to existing facilities to create space for a medical library, teaching and research. It will seek financial support from the California Legislature and the federal government; it has already begun to receive private contributions.

The university now trains medical students for their first two years through the UC Riverside/UCLA Thomas Haider Program in Biomedical Sciences. By 2022, the UC Riverside School of Medicine is scheduled to have a total enrollment of 384 medical students, 160 PhD students and more than 400 UC Riverside-affiliated medical residents.

The doctors are in the house
The AMA's House of Delegates is holding its Interim Meeting Nov. 7-10 in Houston, addressing issues such as health system reform and physician payment.
AMA House - Slideshow - Updates