Governor's Newsletter, Winter 2001-02

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's Annual Meeting Offered Value Prizes and Surprises to Many.

Hundreds of Pennsylvania internists and residents enjoyed a broad menu of scientific programs and special events at the Nov. 2 - 4 Annual Meeting in Pittsburgh. Many thanks to Program Chair Dr. Wesley Kozinn, Director of Continuing Medical Education at Easton Hospital. Highlights included:

  • Use of Hand Held Computers in Medicine
  • "Pittsburgh Style" Transplant Medicine
  • Impact of Sex and Gender on Patient Health
  • Update on Recent Anthrax Scares

A Symposium on the Critical Issues in Managed Care allowed the audience to question the Medical Directors from three prominent providers: Highmark. AETNA and UPMCHP. Attendees asked a variety of questions, and generally voiced appreciation to the speakers for their candor and willingness to explain the reasoning behind many current requirements.

West Penn Wins Jeopardy

Congratulations to the winners of the PA State Medical Jeopardy tournament, held during the PCIM Annual Meeting. The winners are Fadi Alfayoumi, Harchetan Singh, Hiren Shah, Shrividya Karthik and Andreas Achilleos from Western Pennsylvania Hospital, Pittsburgh. The other competing teams were Challa Ajit, Brian Clements, and Parameswaran Hari from Lankenau Hospital, Wynnewood, and Sreenu Ada, Jayanta Choudhury, Madhuri Yalamanchili, and alternate, Rajan Krishnamani of Guthrie Health/Robert Packer Hospital, Sayre, PA. West Penn Hospital's Jeopardy Team will represent the Pennsylvania Chapter at the ACP-ASIM national final tournament to be held this spring at the ACP-ASIM Annual Session in Philadelphia, April 11-14, 2002. Yes, it was Allegheny General Hospital's team that won the national trophy last year, and Western Pennsylvania Hospital was the national runner-up in 1997.

Annual Meeting Sponsors

PCIM gratefully acknowledges commercial support from the following exhibitors: Aventis Pharmaceuticals, who also gave an unrestricted educational grant; Bayer Pharmaceuticals, Lifescan, PhyzBiz, Reliant Pharmaceuticals, Wyeth-Ayerst Laboratories, Merck Inc., NovoNordisk Pharmaceuticals, and Pfizer.

December 2001

Call to Action:

Help Stop Cuts To Medicare Fees

Physicians are now facing, effective January 1, 2002, a 5.4% cut in Medicare payments for all services. This is caused by current Federal legislation that ties physician payment updates to the growth in the US Gross Domestic Product. The current economic downturn will result in those reductions unless Congress changes the law that mandates this tie in to the GDP. You can help by contacting your Congressman and U. S. Senators to tell them how a cut would impact health care in Pennsylvania, and to ask them to sponsor and support legislation (Senate bill 1707) introduced by Senators James Jeffords of Vermont and John Breaux of Louisiana. The bill would reduce the Medicare cuts from 5.4% to 0.9% and require the Medicare Payment Advisory Commission to report to Congress by March 1 on replacing the formula.

Is This Hard to Do? No -- To register your thoughts with your Congressman and Senators, simply:

  • Go online to www.acponline.org.
  • In the upper black toolbar, click on Advocacy
  • In the upper right, click on Legislative Action Center
  • In the Action Alert box, click on S. 1707, formerly Senate bill #1660
  • Enter your ZIP Code. Click Go
  • Compose or add to the draft letters provided-do not be timid, say what is on your mind
  • Enter your name, etc.
  • Copy the ACP-ASIM office
  • Click and Send Message at bottom of screen

Thanks!

Save the Date: October 11, 12, 13, 2002. PCIM'S 2002 Annual Meeting Will Be Held in Philadelphia.

Governor's Letter

To Our Members in the ACP-ASIM Eastern Region

Herbert Y. Reynolds, MD, FACP

The annual meeting of the Coalition of Internal Medicine, PCIM, was held in Pittsburgh, November 2-4, 2001. A critiqué of the meeting appears elsewhere. From this participant's perspective (and my wife, Anne who attended also), we were at an exciting location in downtown Pittsburgh at the newly renovated Sheraton Station Square Hotel - interesting places to see, enticing shopping, an arcade close by and a succession of excited football fans staying at the Sheraton Station Hotel - a college game on Saturday and the professional one on Sunday (kept the paddle wheel boats shuttling fans to the stadium). Meals were excellent.

Most important, the quality of the presentations was excellent and the meeting format adaptable. An on the spot decision to discuss current medical issues precipitated by recent bioterrorism infections was appreciated and informative (led by Drs. Matthew Levison and Jeffrey Jahre). Other topics on hand held computing, women's health issues, and transplantation medicine were pertinent. A record number of residents offered clinical or research abstracts for presentation. It was a nice innovation to have residents, who won the competitive presentations, to present their material at the Sunday plenary session. However, there was a paucity of our members in attendance and few people in the audience. This was a disappointment for the quality of the program justified going and participating. Hope you will plan now to attend PCIM's meeting in Philadelphia on October 11-13, 2002.

Allow me to acknowledge the three residents from Penn State's Hershey Medical Center and College of Medicine who made presentations: Drs. Frederick A. Browne (RII), Leo J. Motter (RIII), and Natalia Volkova (RII). Thank you especially and your many other resident colleagues for contributing new knowledge and helpful clinical perspectives.

Recently, we at the Hershey Medical Center enjoyed a visit and grand rounds presentation by Dr. Harold Sox on November 13, 2001. I refer to this for several reasons. Dr. Sox, the new Editor of the Annals of Internal Medicine, was very interested in having input about how this important journal can be more responsive and helpful to its readership. Also, he requested that authors consider submission of their papers to the Annals. The clinical topic he discussed was evidence-based screening for colon and prostate cancer - a most helpful topic. Consider inviting him to your medical center. He also enjoys discussing College issues.

Finally, plan to attend the ACP-ASIM National Annual Meeting in Philadelphia, April 11-14, 2002. These national meetings always offer outstanding Scientific Programs and ideas you can apply to your practice Today.

Abstract Competition Sets Record

Residents presented 80 Research and Clinical Abstracts at the PCIM Annual Meeting.

More than 160 abstracts were submitted to 2001 Associates' Program competition; more than 100 were clinical vignettes. The balance involved research. The specialty with the most entries was cardiology, followed by gastroenterology and infectious diseases. Eighty abstracts were presented on Saturday afternoon in ten sessions. Judges presided over the sessions, and selected a winner in each room. Judging included quality and clarity of the presentation, uniqueness of the clinical observation, value of the teaching point, and the handling of the questions.

The three presenters with the highest scores, Harish Jasti of the University of Pittsburgh Medical Center, Ronnie Mohammed of Abington Hospital, and George Tadros of Geisinger Medical Center, presented their abstracts to the general session on Sunday. Once again, the Associates' Program abstracts competition was a highlight of the Annual Meeting, as well as offering a valuable learning experience for residents.

PCIM Services - Our Advocate Reports

John Nikoloff, President of Capital Associates, is public affairs consultant and lobbyist for PCIM Services, our advocacy organization. Below is an update on current issues in state government that we feel directly impact the practice of internal medicine in Pennsylvania.

PCIM Again Opposes CRNP Scope of Practice Expansion

PCIM is opposing legislation that would put regulation of Certified Registered Nurse Practitioners under the sole jurisdiction of the State Board of Nursing. Rep. Pat Vance of Cumberland Co. ( HB 2121) and Sen. Jane Earll of Erie (SB 1208) are prime sponsors of legislation that would accomplish this if enacted. PCIM has consistently opposed legislation to expand the scope of practice for CRNPs without physician supervision, most recently in blocking HB 50 during the 1999-2000 legislative session.

As written, the bills would allow the Board of Nursing to establish regulations governing prescriptive authority, documentation standards, and scope of practice by nurses. PCIM Council voted recently to oppose this legislation and other legislation that would remove regulation of medical acts from the responsibility of the Board of Medicine.

Your lobbyists in Harrisburg are working with the Pennsylvania Academy of Family Physicians to oppose this legislation, or to amend the act to maintain existing regulations governing CRNPs' prescriptive authority and physician-CRNP collaborative agreements.

PCIM is Working to Prevent Direct Access for Physical Therapists

The House Professional Licensure Committee has voted out SB 400 , a bill which would permit physical therapists to treat patients for up to 30 days without a physician referral. This would be a significant reversal of state policy, and a move that PCIM has opposed for about a decade. PCIM's lobbyists worked with other medical groups and with the insurance industry to amend legislation in Committee. The amendments limit PT's ability to receive direct payment for services, and give insurers the right to insist on physician referral. PCIM will continue working to keep these provisions in the bill.

PCIM Supports Venue Amendments

PCIM lobbyists have been meeting with legislative leadership to seek changes in a law to require a lawsuit be brought in the same county in which the alleged malpractice occurred, to stop lawyers from changing venue in hopes of a higher award. PCIM is working to get amendments to HB 1802, a CAT Fund Privatization bill, which was recently approved by the House Insurance Committee. When the bill is considered by the full House, Rep. Bob Godshall (R, Montgomery) will offer an amendment to require med mal lawsuits be filed in the county where the alleged medical malpractice occurred. Rep. Godshall intended to offer the amendments in the committee, but instead chose to hold the amendments for consideration by the full House.

CAT Fund Privatization, Med Mal, Medical Errors Legislation Still in Negotiation

The House Insurance Committee has moved HB 1802 out of committee by a 22-2 vote, and the bill is now on the House Tabled Calendar. This bill may be used as a vehicle for Rep. Godshall's amendment. HB 1802 would transfer responsibility now with the CAT fund to the private sector, and provides for paying down the unfounded liability in the fund while phasing it out over a six year period. The bill also caps future surcharges.

PCIM Seeks Regulation of HMOs, PPOs

PCIM is supporting additional legislation to regulate the state's managed care organizations. A coalition of health care providers is seeking legislation to expand the provisions of Act 68 to all managed care plans. PCIM will work to seek extension of the legislation to all plans with utilization review, and to have physicians on any review panels where medical acts are being reviewed. In addition, the PCIM will seek a statewide definition of "medically necessary." PCIM has also endorsed legislation that would require all commercial insurers with pharmacy benefit plans to meet statewide standards.

Save the Date: Our next Annual Meeting will be October 11, 12, 13, 2002 in Philadelphia.

Eakin Wins Supreme Court Seat

Pennsylvania voters gave Republicans a 4-3 majority on the state Supreme Court for the first time since the '60's by electing Superior Court Judge Mike Eakin to the state's highest court. Eakin won with 52 percent of the statewide vote in his election to the Supreme Court over Democrat Kate Ford Elliott. PCIM had endorsed Eakin for the seat. Judge Eakin has acknowledged the role physicians played in his victory margin.

His election sets the stage for two important issues to be decided by the Supreme Court. Proponents of tort reform now find a court that should be more than willing to listen, and to make changes to the state's civil justice system. Eakin, a strong supporter of reform, may cast the deciding vote on critical issues relating to rules of evidence, frivolous lawsuits, venue legislation, and even a revisitation of a court ruling in 1996 on medical malpractice reform.

Senator Murphy Urges Advocacy at PCIM Annual Meeting Dinner

State Sen. Tim Murphy (R, Allegheny) spoke at the PCIM Annual Meeting in Pittsburgh, telling the attendees that legislation will be moved next spring to reduce the strains on the PACE program and help senior citizens better manage their costs for therapeutic drugs. Murphy, sponsor of SB 700 (continued above) , said that without legislative action, the PACE fund would be bankrupt in a few years.

Murphy urged PCIM to get involved with its voice, its grassroots and its financial support to increase its ability to influence the legislative and regulatory scene in Harrisburg.

Did You Know?

According to the data, the median verdict in a medical malpractice case tried in Philadelphia is more than double the median in those cases from the rest of the state. Data from January 1994 through August 2001 shows that the median verdict for medical malpractice cases in Philadelphia was $972,909, while median in those cases from the rest of the state was less than $410,000.

For years, doctors have complained that overly aggressive trial attorneys often try to have cases pulled into the Philadelphia court system, where juries are known to hand out unreasonably high awards. Doctors say that the lawyer's incentive for using a Philadelphia court is because the attorney stands to make more money, as they'll often keep up to 40 percent of the award. The current rules of court permit this.

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