Corner not turned on malpractice crisis

To celebrate anything or draw any conclusion from the 2006 decline in premiums would be a mistake. Six times in the past 14 years Pennsylvania’s liability payouts have declined – only to be followed by substantial increases in following years.

Gov. Rendell misleads public & print media

Gov. Rendell is cynically attempting to trick the media and public by saying "lawsuits" are down while the number of doctors sued trends significantly upward.

A fight we can't afford to lose

While P.A.P.A. is still fighting for tort reform at the state level, the best hope for physicians is presently in the United States Congress.

Health insurance markets out of whack

Federal regulators continue to turn a blind eye toward the reality that in much of the country health insurance markets are not competitive.

Cap noneconomic damages, attorneys' fees

Pa. Senate Majority Whip Jeffrey E. Piccola makes the case for caps. 

Caps for medical malpractice only

Pa. Senator Connie Williams argues that caps on noneconomic damages are needed in medical malpractice case, but not for product liability.

'Dirty little secret' of the malpractice crisis

Lawsuits against physicians, frivolous or not, would not be filed unless one doctor is willing to testify against another doctor, under oath, for money.

Malpractice insurance fix needs more work

We have given the insurance companies some of the tort reform that they have asked for. Now it is time for the insurers to do their fair share.

Where have all the doctors gone?

If third party payers are unwilling to work with physicians, argues C. Richard Schott, M.D., they will have to deal with, and be responsible for, the resultant deterioration in quality and the disruption of access to care that surely will result, not from physician initiated job actions, but from existing market forces, resulting in the inability of a decreasing number of the physicians remaining in this region to meet the medical needs of their subscribers.

Balancing nursing autonomy with quality of care

Pending legislation would dangerously expand nurses' scope of practice, argues Pennsylvania Medical Society President Donald H. Smith, M.D. Solutions for the issues that the legislation purports to address are found in proposed regulations, which provide prescriptive authority for CRNPs.

Health care mergers must receive oversight

Whenever nonprofit health care entities convert to for-profit or merge with other nonprofits, these public investments, and the benefits they bring to a community, are jeopardized. The role of the Commonwealth must be to insist on scrupulous review and community input in every case.

New evaluation and management guidelines

New evaluation and management guidelines have provoked considerable anger in physicians, and for good reason, according to PA Society of Internal Medicine President-Elect Thomas Brandecker, M.D.

Managing alcoholism as a disease

Advice for physicians about how to approach patients suffering from alcoholism.

Stretching your medical mission

Medical relief projects allow physicians to transcend the way they see their daily patients while fostering personal or spiritual commitments.

Healing academic medicine

For academic medical centers to survive and thrive, they must adopt a certain stance toward their clinical researchers. Institutions must make clear policy commitments to endowments, to student mentoring, to clinical care and to salaries, or risk the fall of academic medicine.

Pitfalls of physician-assisted suicide policy

Hilary Evans, M.D. appraises physician concerns and criteria with which to judge the moral grounds of the issue. Medical progress, patient vulnerability and professional codes lead Evans to a reasoned rejection of physician-assisted suicide.

The renaming of medications as a means of marketing new indications is a dangerous semantic and treats physicians like naive consumers who care more about a logo than the science that logo represents.

Public confidence in managed care has been eroded by increasing media scrutiny and legislative tinkering, observes Neil Bohnert, who descibes a collaborative alternative to unilateral mandates, which incorporates the interests of physicians, insurers, health care providers and others.

Loss of personal choice of one’s doctor leads to the more central question of whether doctors are really necessary at all. A satirical look at the possibilities available.

Steven Bush, M.D., depicts a little-acknowledged problem of bureaucratic billing burdens of fee-for-service—on the patient. The sanctified system encroached upon by managed care is not without its own flaws, from a patient perspective.

Carey Vinson, M.D., M.P.M., makes the case that Medicare HMOs meet the challenge of caring for the geriatric population while holding the line on Medicare spending. Vinson applauds the use of innovative approaches such as disease state management and case management, illustrated by successful working models, as viable alternatives to physician reimbursement reduction approaches to Medicare cost control.

Physician unions will erode physicians' greatest asset: the relationship they have with their patients, argues James Unland, acting executive director of Millennium Physician Organization.

Gordon K. MacLeod, M.D., itemizes warning signs for medical education’s future. The signs represent a trend to be reckoned with.

Dissatisfaction with medical practice is higher than you might expect. Learn how doctors in the state view medical savings accounts, single payer system and other policy priorities, and how for-profit marketplace priorities compare to those views.