AMA Head Handles Many Issues
Donald Palmisano, president-elect of the American Medical Association, is a very busy man these days, fending off attacks that the doctors’ lobby is blackmailing the American public and taking its patients “hostage” in an increasingly aggressive fight against America’s trial lawyers. Luckily, Palmisano has a law degree-so at least he knows his enemy.
As point man for the AMA, Palmisano, a New Orleans surgeon, is engaged in a rapidly escalating war of words in the AMA’s effort to limit the amount of damages in malpractice lawsuits.
The most recent volley-and by far the most provocative-came from an influential law professor in Washington, who accused the doctors’ lobby of “medical terrorism” for using patients to try to force a change in tort laws.
Jonathan Turley, a law professor at George Washington Law School, denounced the actions of about 30 doctors who walked off their jobs at West Virginia hospitals earlier this month. That’s a form of blackmail, Turley suggested. “These latest walkouts are nothing short of hostage-taking: demanding huge benefits in exchange for basic medical care for captive patients,” Turley declared in a commentary published Jan. 6 in the Los Angeles Times.
He also took direct aim at the Chicago-based AMA. “We have long followed a policy of not negotiating with hostage-takers; it shouldn’t matter whether they are from the SLA or the AMA,” Turley wrote.
Never known to back down from a good fight, the AMA responded in kind. Palmisano, who is no stranger to forensics, said in a written response in the Times, “It is appalling to equate the front-line physicians caring for America’s patients with the cowardly and murderous intentions of hostage-takers.”
Palmisano, the AMA’s mouthpiece on tort reform for several years, is much in demand by the media since the New Year’s Day walkout in West Virginia focused national attention on the issue, highlighting the increasingly rebellious nature of some angry and frustrated physicians. He’s a natural in the role. At the end of a debate with Ralph Nader last week on CNN‘s “Crossfire,” Palmisano came up with a measured comment meant to appeal to just about anyone who has ever been sick. “Let’s not forget the patient. Let’s make sure we have doctors.”
At least some Medicare relief
Those who attended a recent federal relations forum in Washington hosted by the Premier hospital alliance walked away with a little something to help alleviate their congressionally induced frustration. As hospitals, physicians and others continue their concerted but uphill lobbying effort to increase Medicare reimbursement rates, Premier’s squeezable red ball, etched with the words U.S. Congress, might provide some relief.
Instructions for use: “To combat extreme stress stemming from congressional action (or inaction), remove ball from box and squeeze slowly and repeatedly. To protect against recurrence of symptoms, squeeze twice upon arrival at work and twice upon departure. Administration, on an as-needed basis, is permitted during protracted budget battles. Dangers of overuse are negligible.”
With a full slate of tough issues to resolve-Medicare prescription drug coverage for seniors, tort reform, Medicaid shortfalls and regulatory relief-the little red ball may be bouncing all over Washington this year.
There may be no better sign that nontraditional medicine is gaining a foothold-albeit a tenuous one- in the U.S.: Someone has started an awards program for it.
A quarterly paper called Traditional Chinese Medicine World, New York, announced in its 2002 winter issue its choices for the top schools of Oriental and Chinese medicine.
According to TCM World, there are more than 70 such schools. Fifty-three of those, in 14 states, have been accredited or are candidates for accreditation by the Accreditation Commission for Acupuncture and Oriental Medicine, a federally recognized organization. Most states that license for acupuncture require practitioners to graduate from a four-year ACAOM-accredited school, according to commission Director Dort Bigg.
Bigg thinks the TCM World report has done little to improve complementary medicine. He says the ranking is “riddled with inaccuracies” and based on inadequate research.
Lost in space
Emergency surgeries, operations where there is an unexpected change in plans, and overweight patients are the three highest risk factors precipitating the much feared but relatively rare medical errors resulting in objects left inside patients after surgery, according to a new study.
Researchers at Brigham and Women’s Hospital, Boston, found that in the relatively few instances in which patients are sewn up with sponges or surgical instruments still inside, the errors tend to happen at such critical and unpredictable times.
The study, published in the Jan. 16 edition of the New England Journal of Medicine, analyzed malpractice claims filed with one insurance company from 1985 to 2001. In total, 54 cases at 22 hospitals were found to involve forgotten objects-69% involving sponges and 31% involving surgical instruments. The cases were then compared with data from patients undergoing the same operations who did not suffer the complication, and the researchers concluded that retained object errors are nine times more likely to happen in emergency situations. The risk is four times as likely in operations where there is a change in procedure. Obese patients are at greater risk because they provide ample space in which surgeons can lose equipment or sponges, the authors said.
In total, the researchers extrapolated that at least 1,500 errors of this type occur in the U.S. each year. Ouch.
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