A message to all physicians from AMA President Nancy H. Nielsen, MD, PhD.

As our country hurtles toward health system reform, Medicine has been at the table during the discussions. The American Medical Association and the specialty and state society leaders have had access to and have been engaged with the White House and the key committees in Congress.

We have been working closely with top Obama administration officials and key staff members of both parties. We have given our best advice, and we have taken the time and effort to carefully consider all views. In truth, we’re not just at the table; we’re helping set the stage for our nation’s future.

But as Sen. Jay Rockefeller (D, W.V.) said recently, “There’s too much happy talk. It’s time to start thrashing out decisions on the tough issues.”

We couldn’t agree more, which is why we need to keep focused on precisely what the issues are that are driving the current debate.

The first is cost. Our nation spends more than $2 trillion per year on health care, and there is nothing in today’s health system to stop costs from increasing beyond our nation’s ability to pay for it.

In fact, everywhere you look you can see the cracks: 46 million uninsured; millions more underinsured; patients putting off preventive care and buying needed prescriptions to save money for things like rent and food. If we all don’t control costs, our nation is in deep trouble.

Physicians can’t and shouldn’t be held responsible for all medical costs, obviously. But we order and are involved in many of the costs, way beyond our own services. We deserve to be paid fairly for our services.

We also have a professional responsibility to be just stewards of finite resources. We have to be concerned about what works better than something else, about what costs more (for our individual patients and our country) than something else, and about honoring the wishes of our patients while giving them information on which to base informed choices.

We also have a right to point out the administrative costs we physicians have had to bear in this fragmented health care “system.”

The second issue driving debate is quality. We’ve taken a leadership role on quality throughout the history of this association, not just recently. But recent history is instructive.
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Physicians can receive up to $44,000 over a five-year period for the use of HIT

CHICAGO – As part of its continuing efforts to help physicians learn about and adopt new technology, the American Medical Association (AMA) today announced a new, free webinar series that will help physicians understand the health information technology (HIT) provisions laid out in the recently passed economic stimulus bill. The three-part series will lay out what these provisions mean for physicians and how they can take advantage of the $19 billion in funds allocated for the purchase and use of HIT. The first webinar is Thursday, May 21.

“The stimulus bill marks the first significant federal investment in HIT and offers both financial benefits for physicians and the promise of national standards that will increase the interoperability of systems,” said AMA Board Chair-Elect Rebecca J. Patchin, M.D. “As new information becomes available, the AMA will tap experts and health care leaders to review key components of the stimulus bill and offer insights on what they mean for physicians.”

The schedule for the webinar series is below.

· Stimulus 101: Basics of the Health Information Technology Provisions – May 21, 12:00 PM CT

· Stimulus 102: Update on the Health Information Technology Provisions – June 9, 2009, 12:00 PM CT

· Stimulus 103: Real World Perspectives – July 14, 2009, 12:00 PM CT
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It looks like a few rule changes have dramatically lowered the number of malpractice suits filed in Pennsylvania. There were 1,602 filings last year, a 41% decline from the annual average between 2000 and 2002, before the changes were put in place.

One of the new rules requires a “certificate of merit” from a medical professional, establishing that “the medical procedures in a case fell below applicable standards of care,” according to a recent statement from the Administrative Office of Pennsylvania Courts. Another rule requires cases to be filed in the county where the alleged malpractice took place — an effort to discourage so-called venue shopping, where cases would be filed in counties thought to be sympathetic to plaintiffs.

The number of malpractice cases fell sharply in 2003, when the rules were in place, and have stayed down.

“The results have been extraordinarily impressive in abating the malpractice insurance crisis,” Pennsylvania’s governor said yesterday, the Philly Inquirer reports.

The president of the state’s medical society told the paper the decline in cases is encouraging, but said malpractice insurance rates in the state are among the costliest in the country. A spokesman for the society told the Health Blog that, for the most part, state doctors’ malpractice premiums have been stable or decreased slightly since 2002.

A representative of the state’s trial lawyers group told the Inquirer the group was satisfied with the rules, partly because there are no longer calls for caps on awards in the state.

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The American Medical Association (AMA) recently launched a new online learning center to provide physicians with the information and tools they need to make informed decisions about electronic prescribing (ePrescribing). The learning center can be found at www.ama-assn.org/go/eprescribing.

“The AMA’s new ePrescribing learning center takes the guess work out of the decision-making process by giving physicians all the tools they need to decide what system is best for their practice,” said Joseph M. Heyman, MD, AMA board chairman. “At the end of last year, about 13 percent of physicians were prescribing electronically, but with the incentives available through Medicare’s ePrescribing incentive program and this new AMA resource, I’m certain that percentage will increase.”

The new online learning center includes:
• Complete information on ePrescribing vendors and features;
• Calculators to estimate time savings and determine Medicare ePrescribing incentive payments;
• The latest information on federal and state programs offering ePrescribing incentives;
• Readiness and planning tools to map out an implementation plan.
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The Nevada Supreme Court is taking aggressive steps to resolve a lingering problem in the District Courts of Clark County—a backlog of medical malpractice cases.

During the month of May, two-judge teams of senior judges will conduct settlement conferences in medical malpractice cases at a rate of two a day. Eighteen or more conferences will be set each week. This process has been referred to as the “medical malpractice settlement marathon.”
Justice Michael Cherry, who supervises the Senior Judge Program, said the settlement program will target the 216 oldest cases. Of those, 109 were filed more than two years ago.

“This process will provide unique access to the justice system and to some of our most experienced judges,” Cherry said. “Attorneys with pending medical malpractice cases were sent letters about the settlement program and have been very enthusiastic about submitting their cases for the conferences.”
In his State of the Judiciary speech on March 24, Chief Justice James W. Hardesty told a joint session of the Nevada Legislature that “more than 400 medical malpractice cases are pending today.” These do not include the approximately 430 cases involved in the endoscopy litigation in Clark County.

“While the courts would like to have taken these non-endoscopy cases to trial within the time frames established by the Supreme Court and the Legislature, that simply could not be accomplished in nearly a quarter of these cases because there are not enough judges or courtrooms to do so,” Hardesty said in his address.
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