"Health & Medical News"

Better vigilance is needed to ensure medical research on human subjects is not flawed by financial conflicts of interest, according to the Assn. of American Medical Colleges and the Assn. of American Universities.

In March, the two organizations issued a report that calls on medical schools and research universities to put into place conflict-of-interest policies within two years. Such policies should cover how to identify, evaluate and manage financial conflicts, the report said.

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A recent Minnesota trial court ruling raises questions about whether medical specialty societies should serve as sentinels over expert witnesses in the courtroom.

A Hennepin County District Court judge tossed out claims that the American Academy of Ophthalmology defamed Charles Yancey, MD, when its ethics committee examined his statements as a plaintiff expert in a medical liability case. The investigation followed a complaint made by two academy members. Ophthalmologists Jeffrey R. Weis, MD, and David R. Hardten, MD, were defendants in the lawsuit and accused Dr. Yancey of giving misleading testimony.

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Physicians say a Missouri Supreme Court ruling, though narrow, recognizes the significance of medical staff bylaws and offers doctors some recourse in the face of unfair discipline.

Breaking with a 43-year-old precedent, a unanimous high court opened the door for medical staff members to sue hospitals over privileging disputes if the facilities fail to follow staff bylaws. Justices departed from a long-held principle that hospital privileging decisions were not subject to judicial review, noting that was the “nationwide majority rule” at the time of the high court’s 1965 decision.

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When revelers rang in the New Year, Robert Jarvik, MD, was the star of a massive Pfizer Inc. advertising campaign for Lipitor (atorvastatin). By the end of February, Pfizer had ended the campaign, under the pressure of a U.S. House Energy and Commerce Committee probe.

The committee’s chair, Rep. John Dingell (D, Mich.), charged that the ads misled the public because they created the impression that Dr. Jarvik is a practicing physician, when he is a biomedical engineer not licensed to practice medicine. The committee disclosed that Dr. Jarvik received $1.35 million under a two-year contract set to expire this month, according to media reports.

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From:
Treatment Research Institute
600 Public Ledger Building, 150 S. Independence Mall West
Philadelphia, PA 19106
Tel: (215) 399-0980
http://www.tresearch.org

Paying substance abuse treatment providers for results, not services, may lead to improved quality of care, according to the first published study of a novel performance-based contracting system implemented by the State of Delaware in 2002.

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Walking the line between appropriately prescribing controlled substances and unwittingly contributing to the increase in prescription drug abuse becomes less precarious when certain precautions are taken, say those familiar with the balancing act.

Prescription drug abuse is widespread and on the rise. Nearly 7 million Americans abused prescription drugs in 2005, compared with 3.8 million in 2000 — an 80% jump, says the Justice Dept.

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Washington — Physician relationships with medical device makers came under fire at a Senate Special Committee on Aging hearing last month. So far, legislation is focused on manufacturers’ conduct, but lawmakers and enforcement agencies expressed concern about doctors’ potential conflicts of interest as well.

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One health plan has come to a conclusion that many physicians already have reached: The financial benefits of office-based electronic medical records systems are not worth the cost to doctors.

Relying on information from past studies, including an American Medical Association estimate that doctors see only 11 cents of every dollar saved through the use of information technology, BlueCross BlueShield of Massachusetts recently announced that it has decided not to require physicians to install an EMR to participate in its bonus program.

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A legal dispute in Washington state has doctors worried that their ability to employ other licensed medical professionals — and ultimately compete in health care — may be compromised.

The owner of a physical therapy group is suing an orthopedic practice, saying the doctors are profiting illegally from referrals they make to physical therapists who work for them. Columbia Physical Therapy also claims that state law prohibits Benton Franklin Orthopedic Associates in Kennewick, Wash., from hiring physical therapists at all. Both sides are asking the Washington Court of Appeals to clarify the issue. Judges have yet to decide whether to accept the case.

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In the fall I rotated through the geriatrics ward. One of the attending physicians was an irritating woman whose idea of the Socratic method was pimping you with really vague questions, then acting like she had already thought of whatever answers you gave and that you were only telling her what she already knew. The other attending was a throwback to “the days of the giants,” when pneumococcal pneumonia was diagnosed by injecting sputum into mice and antibiotics for urinary tract infections were tested on agar plates. One morning, one of my interns presented a case to him of an elderly man who had been hospitalized with fever and a cough producing green sputum. “He has pneumonia,” she proclaimed confidently. “Take a look at this chest X-ray.” She pulled up a digital image on a computer screen showing a distinct pneumonic streak. The senior physician waved it off. “First tell me about your lung exam,” he said.

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