News Capsules (Fall 1996)

Author: 
Compiled by Medical Sentinel Editors
Article Type: 
News Capsules
Issue: 
Fall 1996
Volume Number: 
1
Issue Number: 
3

Corporate Medicine: Then and Now

The physician should not dispose of his professional attainments or services to any hospital, by body, group or individual...under terms or conditions which permit exploitation of the services of the physician for the financial profit of the agency concerned.
(AMA, 1949, on medical ethics and the corporate practice of medicine)

Today, the socialized corporate practice of medicine is rampant. But there is hope on the horizon.

A legal doctrine which had been forgotten and ignored (and referred to by Dr. Thomas Jackson Tidwell in this issue in “Reports From the States — The Status of Corporate Medicine in Georgia”) has been resurrected in full force in Illinois.

This doctrine proscribing the corporate practice of medicine forbids “unlicensed entities from practicing medicine — or using economic incentives to sway physicians’ medical decisions.”

On April 12, 1996, the Fourth District Appellate Court of the State of Illinois ruled in Berlin v. Sarah Bush Lincoln Health Center that “a surgeon wasn’t bound by his hospital employment contract because it violated the state’s 1923 corporate practice of medicine law.”

The decision is in accord with the most recent state Supreme court ruling (1936) — namely, that the statute and supporting case still “constitutes a proscription against any type of corporate entity practicing medicine by employing licensed physicians, including nonprofit hospitals.”

The decision has sent “shock waves” through the Illinois medical community and “hospitals and other entities scrambling to rewrite physician contracts.”

Saul Morse, vice president and general counsel with the Illinois State Medical Society asserted that “the case serves as a reminder that doctor’s first obligation is to their patients.”

And Gary W. Eiland, partner with the Houston law office of Vinson & Elkins, underscores, “You look to where the dollars generated by medical practice end up. If they end up in an entity that’s not authorized to practice medicine in the state, the theory is that the physician has improperly allowed another to use his or her medical license.” [Emphasis added.]

(AMNews, May 6, 1996)

 

 

South African Physicians and Dentists Join to Preserve Private Practice

The Association of Private Practicing Doctors and Dentists (PPDD) of South Africa becomes the voice for private practice. PPDD is a national association of doctors and dentists dedicated to preserving freedom of the one-on-one patient-doctor and patient-dentist relationship. “PPDD believes that the patient-doctor relationship must be protected from all forms of third-party intervention; supports the principles of the free market in medical practice; supports the basic right of patients to have Personally-Managed Medical Care, i.e. where the patient and not a third party is in charge of the financial arrangements of the patient’s medical care.

“PPDD is networking with doctors, dentists, and patients to inform the public about true free market reforms which will  reduce the cost of medical care and retain the patient’s right to freedom of choice of doctor and dentist; informs the public, doctors, and dentists about the disadvantages of corporate managed care schemes based on the USA systems; assists patients, doctors, dentists, and the government in structuring and maintaining cost-effective medical care; and urges South African physicians and dentists to join and help them preserve private practice!” Contact Dr. H. Hamersma, P.O. Box 5973, Weltevreden Park, 1715, South Africa. Tel. 27-11-472-3517, Fax 27-11-472-3519.

 

Freedom in Medicine

If you missed the Freedom in Medicine Conferences, “Health Care Reform and You” and “Patient-Doctor Answer to HMOs,” a complete list of video ($15.75 each) and audio ($8.50 each) tapes is available from Dr. Nino Camardese, President, Freedom in Medicine Foundation, 48 North Linwood Ave., Norwalk, OH 44857, (419) 668-8282, Fax (419) 668-8283. All contributions are tax-deductible.


A Statist Solution

Sidney Wolfe, MD of the left-wing advocacy group, Public Citizen, impugned the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), a private agency charged with accrediting hospitals for quality and utilization of health care delivery, for alleged coziness with the hospitals it oversees and its failure to prevent countless deaths by negligent doctors and hospitals. His solution: Government to step in and take over the function!

 

AAPS v. Clinton Update

An estimate by the General Accounting Office (GAO) places at $5.6 million the amount spent by the Clinton administration to develop its Health Security Act of 1993. Another $7.6 million was spent trying to implement it in the legislation, and it spent another $433,966 defending itself from the lawsuit filed by the AAPS (and others) over the violation of the Federal Advisory Committee Act (FACA) and the open meeting laws. The Department of Justice finally succeeded in having the case (AAPS v. Clinton) declared moot after the White House was forced to release 263 boxes of documents. AAPS is also pressing Congress to initiate a congressional investigation while awaiting hearings. The issue of government sanctions remains open.

(The New American, January 6, 1996)

 

Squeezing Blood Out of a Turnip?

A colorful, two full-page spread “Business” editorial in AMNews (July 19, 1996) clamors: “Speciality capitation can work — if you have enough volume and management expertise to track it. By now few doctors hope to stem the rising tide of managed care...many specialists remained above the high-water mark...No more...”

 

Kudos

Congratulations to Jane Orient, MD for her clarion call, “Health Bill Would Shackle Doctors — Literally,” in The Wall Street Journal (May 30, 1996) exposing the criminalization of medicine in the Kassebaum-Kennedy Bill and kudos to Jerome C. Arnett, Jr., MD for his “Ontario’s Health Care: A Pox on Doctors and Patients” (The Wall Street Journal, July 12, 1996) exposing Ontario’s Savings and Restructuring Act aimed at cutting down costs for the unsustainable, demand-side, spiraling Ontario’s single payer system and making physicians civil servants of the state.

Kudos are also in order for Agustin Blazquez and his newly released video — Covering Cuba (1995). This poignant, revealing, and well-done documentary is highly recommended to all Americans interested in knowing the facts about the “golden age” of the Cuban communist paradise.

With fascinating interviews and never-before-seen still photographs, Blazquez demolishes the myth surrounding Cuba’s advances in socioeconomic egalitarianism in general and education and health care in particular. This video provides documentary evidence debunking the purported miracles of the Cuban socialized health care system as propounded by Marxist academic, Vicente Navarro, a member of Hillary Clinton’s Health Care Task Force  who, at the height of the great U.S. health care debate of 1992-1994, recommended the Cuban system of health care for America.

To order, call or write: Agustin Blazquez, AB Independent Productions, 4020 Rickover Road, Silver Springs, Maryland 20902, (301) 949-8791.

 

Capitation...as a Fact of Life?

While many state medical societies have stood for patient choice and physician autonomy, and have fought against managed care “gag clauses” (i.e., Colorado); have moved forward to support MSAs (Virginia, Ohio, etc.) as the true alternative to government-corporate run medicine; and other independent groups such as physicians in Texas are fighting tooth and nail against Medicaid HMOs — others have reportedly caved in to managed care and capitation.

The Oregon Medical Association (OMA) has decided to oppose the physician-led grass roots initiative directed towards proscribing capitation for physicians in managed care networks. Gordon Miller, MD, a Salem-ophthalmologist leads this initiative which was featured in the Medical Sentinel (Vol. 1, No.2, p. 29) “Report From the States: Oregon Initiative — Patient Protection Act of 1996.

A spokesman for OMA told AMNews (May 20, 1996), “We assume the issue will find its way to the ballot and want to make it clear that we favor a pluralistic  approach to physician reimbursement, which would include capitated payments...[O]verall the association realizes that capitation is a fact of life.”

 

Warning!

The Federal Drug Administration (FDA) has set its regulatory sights on physicians using lasers to treat the 60 million Americans afflicted with nearsightedness.

According to the Associated Press (July 27, 1996), “the FDA and the Federal Trade Commission (FTC) issued unusually strongly-worded warnings to stop surgeons from using government unapproved lasers for eye surgery — namely, photorefractive keratectomy (PRK).

The FDA has approved only two lasers — e.g., those manufactured by Summit Technology and Visx — and has warned surgeons they must use FDA-approved lasers (which cost $500,000 each and require the physician to pay a royalty to Summit and Visx of $250 for each eye treated, everytime the device is used.)

An FDA spokesman warns doctors: “Be on the alert: We will take action against illegal products in the marketplace.”

Surgeons say they use non-FDA approved lasers because the FDA is too slow in approving other lasers,   FDA-approved lasers are unable to perform high-power surgery to correct severe refractive errors, and FDA-approved lasers can not perform the newer, developing techniques, e.g. Lasik, which is already replacing PRK in Europe.

 

Books in Brief

 

BioEthics — Opportunities, Risks and Ethics: The Privatization of Cancer Research by Robert K. Oldham, MD, Media America, Inc., Franklin, TN, 1995, 416 pp., ISBN: 0-9628850-1-0, $14.95 (Soft cover), (615) 790-7535.

Dr. Oldham is an internationally recognized oncologist who has written the world’s first textbook on cancer biotherapy. He is also the founder of the Biological Therapy Institute and thus immensely qualified to argue that in cancer research, like in traditional Hippocratic medicine, ethical conduct “is simply a matter of doing that which is right,” and he challenges the government-academia monopoly of medical research and the dogmatism of medicine’s “mainstream” bioethicists. He proposes the attractive idea of medical research privatization allowing patients to pay for research otherwise denied them.

 

Reinventing Health Care by Jack J. Tawil and Frederick Bold, Research Enterprises, Inc., Publishing Segment, P.O. Box 3081, Richland, WA 99352, 1994, 328 pp., ISBN: 1-883021-12-0, $23.95 (Hard cover).

According to the authors, “This book was written to influence the current debate in health care reform and to present the American people with an alternative....” That alternative is the establishment of a competitive market for health care. With their bold and comprehensive proposal, these authors (who both hold PhDs in economics) hope to slash health care costs and craft incentives to eliminate unnecessary medical procedures.

 

A History of Medicine. Volume I: Primitive and Ancient Medicine by Plinio Prioreschi, 2nd edition, 1995, 596 pp., ISBN (Volume 1): 1-888456-01-9, $115.00 (Hard cover), Horatius Press, P.O. Box 241527, Omaha, NE 68124.

This is the first installment of a monumental 3-volume set on medical history. The reader will find this volume a variegated treasure of precious medical history: Primitive and naturalistic medicine; Chinese, Hindu, Egyptian, Mesopotamian, Persian, Biblical and Pre-Columbian medicine. This comprehensive first volume belongs in the library of every aficionado of medical history and, of course, within the easy grasp of all well-rounded practitioners and medical historians. It should be thumbed thoroughly by physicians in search of their past and who heed Alfred North Whitehead’s admonition that “a science which hesitates to forget its founders is lost.”

 

Miami Medical Team — Testimonio de Humanidad by J.A. Albertini, 1992, 264 pp., ISBN: 0-917049-63-2, (Soft cover), Saeta Ediciones, P.O. Box 440156, Miami, FL 33144-0156. Tel. (305) 596-9775.

For those of you who speak (and read) Spanish, this book recounts in vivid detail the humanitarian actions of a group of Cuban-American physicians, the Miami Medical Team led by founder and President Manuel Alzugaray, MD, who dedicated their time and risked their lives to bring medical care to the freedom fighters of Nicaragua (the Contras) and other freedom lovers in Africa (Angola), Asia (Afghanistan), and Central America (El Salvador). —MAF

Originally published in the Medical Sentinel 1996;1(3):3-5. Copyright ©1996 Association of American Physicians and Surgeons.

 

 

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