Governor's Newsletter, Summer 2002
Update from PCIM
Editor's Note: This mailing is a periodic communication with the members of PCIM. Your comments and suggestions are welcome and should be sent to pcim.hq@verizon.net.
PCIM Protects Internists in CAT Fund/Med Mal Fight
After months of internal battles in the Capitol, Governor Mark Schweiker recently signed Act 13 of 2002, in an attempt to "solve" the problems of patient safety, medical malpractice premium hikes and the CAT Fund liability.
Signing of the bill represented a victory for PCIM's lobbying effort on behalf of its members. In a previous version of the legislation, the bill passed the Senate with a provision collapsing the rate system for CAT Fund payments to a maximum of eight, to be determined by the Insurance Dept.
PCIM led a lobbying effort with the Pennsylvania Academy of Family Physicians to correct this potentially devastating amendment. As a result of intensive lobbying in both Republican and Democratic caucuses and of grass roots lobbying by PCIM members, the House restored the current rate class system.
Several members of the House of Representatives spoke out for general internal medicine in caucus and on the house floor. Among these, and deserving our special thanks, were Representatives Pat Vance of Cumberland County, Matt Baker of Tioga County, Ellen Bard of Montgomery County and John Maher of Allegheny County.
The final bill, HB 1802, retains all 16 rate classes for CAT Fund payments, and we avoided any language dealing with "loss of pleasures of life". In addition, the bill puts in place a statute of repose for actions on medical liability. All three actions were major victories for Internal Medicine.
The Statute of Repose section of the Act was another significant change, and now asserts that no cause of action asserting medical liability claims may be commenced after seven years from the alleged tort or breach of contract. The only exceptions are injuries caused by foreign objects left in the individual's body, and a break off age of 20 years if a cause of action relates to an injury to a minor. Those actions must be brought within two years after the death.
A final major roadblock to the bill was whether the legislature would consider the issue of venue. A disproportionate number of medical malpractice actions are filed every year in Philadelphia, where jury awards average twice that of the rest of the state. PCIM had lobbied for legislation to require a lawsuit be filed in the county where the alleged malpractice occurred. The Act establishes an Interbranch Commission on venue, with representatives of the Court, the General Assembly and the Attorney General, which is charged with reviewing the problem and making recommendations to the General Assembly for changes by September 1, 2002.
Annual Meeting
October 11-13, 2002
Join your colleagues at the Pennsylvania Coalition for Internal Medicine Annual Meeting in Philadelphia at the University of Pennsylvania's Houston Hall. Topics include: Critical Care Ethics, Cancer Screening, Obesity, Adult Immunizations, Prevention of MI, Patient Safety and Medical Errors. Check the meeting brochure (coming soon) for details.
Governor's Letter
Herbert Y. Reynolds
Eastern Pennsylvania Region
Prior to the Annual ACP-ASIM Meeting in Philadelphia, April 11-14, 2002, the Board of Governors' Meeting occurred April 8-10, 2002; it was an important time to share ideas again about the college, since the September 11 events had canceled the previous fall BOG meeting. Discussion of resolutions, presentations about ABIM recertification proceedings between ACP-ASIM and ABIM, and informational updates about professional reimbursements, etc. consumed much of the time, but deliberations were reasoned and helpful. Several of the salient items/issues:
1) ACP-ASIM and ABIM negotiations. These will continue on recertification: a) it is anticipated that certain College educational materials, MKSAP and CME courses, will be accepted or substitute for the ABIM learning modules; b) ways will be found to facilitate subspecialists also obtaining their general medicine recertification (retaining), which is considered very important; c) reducing redundancy in the credentialing process is essential; d) creating variable pathways leading to recertification is desirable; and e) remaining sensitive to costs and time is important - all will be factored into the negotiations.
2) Key presentations: a) Prevention of medical errors was addressed by James Batian, an astronaut physician-surgeon, who has been a consultant for the VA medical system on reducing the error problem. He stressed that groups should focus attention on "near miss" or "close call" situations and devise methods to prevent these "almost" occurrences. Maintaining confidentiality for people who bring forward the error problems is mandatory for the group to function effectively. b) Physician-industry relations (presented by Dr. Jay A. Jacobson, Head of Medical Ethics, University of Utah Medical School). Attention to the ethical ramifications of this subject is important, given pharmaceutical marketing, educational support and clinical research, all entwined. c) "Listening to Patients," a talk presented by Dr. John H. Stone, a cardiologist, poet and Associate Dean at Emory University, was good for physicians to hear and reflect about - the uniqueness of patients telling their story, how it helps with making the diagnosis, and importantly, this can be therapeutic for the physician as well.
The educational sessions offered by the ACP-ASIM at this year's Annual Session College were excellent, as always, and updates were well attended, informative and current. What fun! I particularly appreciated the "Multiple Small Feedings of the Mind" presentations which have become popular sessions at the meeting. I want to express appreciation to my colleagues from Penn State's Hershey Medical Center for their offerings (these presentations were organized by Noel Ballentine) and featured: Richard J. Simons on "hypertension," Gregory M. Caputo on "perioperative consultative medicine," Graham H. Jeffries on "common diseases uncommonly diagnosed (celiac sprue and hereditary hemochromatosis)," Luanne E. Thorndyke on "cancer screening in the primary care setting," and Kevin Gleeson on "sleep apnea."
Several more meeting items:
- Congratulations for a clinical vignette poster finalist - Progression of Pre-Transplant Monoclonal Gammopathy of Unknown Significance to Post-Renal Transplant Lymphoma, George M. Tadros and James E. Hartle - Geisinger Medical Center, Danville.
- We were pleased that 27 members from the Pennsylvania Eastern Region were inducted as Fellows of the College at the Convocation, April 11, 2002.
- Congratulations!The Pennsylvania, Delaware, and Ohio chapters had a joint reception on Friday, April 12, 2002 which was really well attended, festive, and enjoyable.
Local activities of the Governor: I appreciated visiting with interested internists, residents and College members at St. Luke's Hospital, Bethlehem, March 26, 2002 and at Chester Crozer Medical Center, Upland, April 19, 2002. After a format of medical grand rounds (about diagnosis and management of multi-organ systems involved with sarcoidosis which has been my medical theme recently), a town meeting is held with housestaff and attendings. The participants have always asked good questions about what ACP-ASIM is doing. Challenging comments are made (usually from residents) about the future of general medicine (economics, malpractice, and competition with hospitalists), how to get started in practice, educational needs, recertification, etc.; these questions all are insightful. I have visits planned to Scranton-Temple, Scranton, May 31, 2002 and Guthrie Clinic, Sayre, October 18, 2002.
Congratulations to ACP-ASIM Fellows elected in 2001:
Christine A. Byrnes - Lower Gwynedd
Marilyn S. Daroski - Pittsburgh
John M. Draganescu - Darby
Donald E. Fetterolf - McDonald
John K. Finkle - Wynnewood
Carmen Guerra - Philadelphia
Mohamed H. Hassan - York
George W. Heffner, Jr. - Orwigsburg
Susan K. Irby - Pittsburgh
Bachar Kassem - Monroeville
Maqsood A. Malik - Pottsville
Scott Manaker - Philadelphia
Walter J. O'Donnell - Pittsburgh
Marc I. Sandberg - Doylestown
David C. Schaefer - Hanover
Radhika Srinivasan - Philadelphia
Glenn L. Stoltzfus - Lancaster
Douglas F. Turtzo - Nazareth
James J. Walsh - Sayre
…and Congratulations to ACP-ASIM Fellows elected in 2002:
Alan M. Berg - Pittsburgh
Geoffrey L. Braden - Bala Cynwyd
Theresa A. Burick - Mechanicsburg
Joanne T. Connaughton - Darby
Steven M. Ettinger - Harrisburg
Farid T. Fata - Danville
Jyothi K. Gella - Johnstown
Eric J. Gertner - Macungie
Sun Tak Han - Chinchilla
Margaret L. Hoffman-Terry - Allentown
William F. Iobst - Allentown
F. Wilson Jackson - Camp Hill
Alfred J. Joseph - Hermitage
Gina M. Karess - Allentown
Louis P. Leite - Camp Hill
Mark A. Lopatin - Jamison
Antonia A. Mendoza - Pittsburgh
Usha K. Mohandas - Corry
Mary F. Morrison - Wynnewood
Rajani K. Pathak - Dubois
James M. Ross - Macungie
Matthew H. Rusk - Philadelphia
Hayman S. Salib - Easton
Kathy J. Selvaggi - Kittanning
Ajay Shetty - Scranton
Mary E. Singer - York
Kelly A. Spratt - Philadelphia
Margaret M. Still - Mifflinburg
Julie A. Stone - Jamison
Edward M. Tsai - Indiana
Stephen A. Volk - Allentown
Lewis V. Whitman - Allison Park
Frivolous Lawsuits - It's about time someone noticed!!
PCIM had worked with legislative leadership for passage of Senate Bill 406, which would have helped to curtail frivolous lawsuits. Early this year, an agreement between the Supreme Court and the General Assembly led to the Court's decision to take on the issue itself. In late April, the Supreme Court approved Rule 1023, which is designed to reduce the time spent in courts on cases where the claims - or defenses - cannot be proven reasonably in court.
Under Rule 1023, parties in a lawsuit now have a 28-day time frame where differences can be resolved before asking for a hearing. A judge is empowered to strike frivolous claims and materials from the pleadings and can even mandate fines. In the past, people who were hit by frivolous suits would have to win and then sue for damages. The new rule also holds the lawyers' law firm responsible for violations, and establishes procedures, sanctions and guidelines for dealing with frivolous claims
Don't Forget to Do More Than Vote
The 2002 election cycle is a critical time politically. We will be electing a Governor, 19 Members of Congress, 25 State Senators and 203 State Representatives. PCIM is working with the staff of the major gubernatorial candidates to insure that they understand the needs of practicing internists and residency programs. Likewise, we are keeping up the pressure on House and Senate candidates to educate them to the real needs of the state's health care system.
Last year, PCIM endorsed Judge Michael Eakin for the State Supreme Court. His election has made a significant change in the way our court system views tort law and medical malpractice lawsuits.
Vote …
This year's election also provides you with an opportunity to make your views and needs known. Take time to get involved this year. Vote. Get to know the candidates and how they stand on issues important to you. Let them know you are interested in their positions. And if you get a chance, participate in local fundraisers. Building strong relationships starts at your local level.
Western Penn Team Earns Strong Second in National Competition
by Lazaros Nikolaidis
The annual National "Doctors' Dilemma Challenge" (also known as "Medical Jeopardy" competition) took place at the ACP-ASIM's recent Annual Session in Philadelphia. Twelve teams of internal medicine residents, representing regional winners across the United States, qualified for the final round.
Among them, and the "pride of PCIM," were the 2001 Pennsylvania State champions from the Western Pennsylvania Hospital. The three members, Fadi Alfayoumi, Harchetan Singh, Hiren Shah, coached by Chief Resident Andreas Achilleos, qualified at the Western Regional by defeating last year's National Champions from Allegheny. They then went on to capture the state championship by beating Eastern (Lankenau) and Central (Guthrie) PA winners.
In Philadelphia, West Penn defended the National trophy captured by another Western PA team, Allegheny General, last year in Atlanta. The team from West Penn performed strongly in a very close "National Final" against teams from Texas, West Virginia and Florida. All of the "final four" teams answered the "Grand Final Jeopardy" question, a case of hairy cell leukemia. After a roller-coaster game, West Penn lost to The University of Texas at Galveston by a single point: 681-680.
Yes, after a score like that there was the anticipated disappointment of missing the "gold". But bringing home the "silver" is no small achievement! Congratulations to our Western PA team for earning second place honors in such a prestigious national contest! West Penn: you did a yeoman's job and made us all proud once again! Look forward to carrying this great Western PA tradition into the next academic season.
Lazaros Nikolaidis, MD is Instructor of Medicine, MCP-Hahnemann University; Division of Cardiology, Department of Medicine, Allegheny General Hospital, Pittsburgh, PA. He has directed the PCIM state-wide "Doctors' Dilemma Challenge" for the past two years. For more information, he can be reached at lazaros@pol.net.
What's New
Contact Information
Eastern Region
Richard J. Simons, MD, FACP, Governor
Southeastern Region
Charles Cutler, MD, FACP, Governor
Western Region
Alejandro R. Gonzalez, MD, FACP
John Derrickson
Executive Director
Phone: 610-543-6880 or Toll-free: 800-846-7746
Fax: 610-543-6806
E-mail: pcim.hq@verizon.net