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From the April 1999 ACP-ASIM Observer, copyright © 1999 by the American College of Physicians-American Society of Internal Medicine.

Proposed data bank change would expand reporting of physicians

The College is fighting a proposal that would expand the number of physicians who get reported to the National Practitioner Data Bank.

According to a proposal from the Department of Health and Human Services (HHS), physicians who provide care that is later subject to a legal claim or action would go on file with the data bank, even if they were never named as defendants in the legal action. Under current rules, an insurer or other entity must report payments made on behalf of parties named in a malpractice case judgment or settlement.

In a Feb. 18 letter to HHS's Bureau of Health Professions, the College said that the new reporting requirements run contrary to the statute that created the data bank. "This is clearly inconsistent with the language of the statute," said ACP-ASIM President Harold C. Sox, FACP, in the letter urging withdrawal of the proposal.

The HHS proposal also calls for insurers to identify physicians as participants in medical actions or claims, even if they were not labeled as such by the injured party or the court. Under this scenario, physicians could become subject to future malpractice claims regardless of the circumstances involved with the original payment.

In his letter, Dr. Sox also pointed out that these problems could become more serious if information in the data bank is made public, as proposed recently by some members of Congress.

The proposal also could harm medical residents because insurers would be required to report housestaff whose actions were subject to a claim. That raises the fear that mistakes made by physicians during their training could be held against them in later years. Currently, most hospitals try to protect residents by getting their names removed from malpractice claims.

Coalition urges Congress to pursue medical liability reforms

The National Medical Liability Reform Coalition is urging Congress to address medical liability reform in the health system reform debate. The College is a member of the coalition.

The coalition, which includes physicians, patients, hospitals, nurses and insurers, sent a letter to House Speaker J. Dennis Hastert (R-Ill.) urging him to continue trying to reform the medical liability system. Last year, Rep. Hastert chaired the House working group on health care quality, which included liability reforms in its proposal to overhaul the health care system.

The coalition supports the following reforms: a cap on noneconomic damages; periodic payment of future damages; elimination of double payment of losses; a reasonable statute of limitations; a sliding scale for contingency fees; and proportionate liability among all parties.

Preparing physicians to deal with the effects of bioterrorism

ACP-ASIM is proposing to work with the AMA and other health care organizations to help prepare physicians to deal with the health effects of bioterrorist attacks.

In a Feb. 16 letter to the AMA, ACP-ASIM President Harold C. Sox, FACP, urged the AMA to take the lead in galvanizing organized medicine to work with physicians to develop a federal structure that responds to the needs of the public if a bioterrorist attack occurs. Dr. Sox also urged the AMA to develop and disseminate antidotes to treat conditions caused by exposures to various biological agents.

Public health officials are concerned that if terrorist acts produce an epidemic of diseases such as smallpox or anthrax, physicians may fail to correctly diagnose the conditions because they are so rarely encountered. To address these concerns, the College is advocating development of a method to quickly evaluate medical conditions of victims of chemical agents.

In the letter to the AMA, Dr. Sox also pointed out that physicians will need to know that antidotes for such chemical agents are available in an ample supply for the public in the event of an emergency.

ACP-ASIM's Key Contact program to recognize advocacy

The College's new Key Contact Incentive Program will recognize ACP-ASIM members who have sent strong messages to their legislators on important advocacy issues.

The goal of the program, which was created by ASIM in 1995, is to acknowledge efforts by members who have developed relationships with their legislators and to encourage College members to become more active on important policy issues. Numerical values will be assigned to communications made by College members with members of Congress such as personal visits, telephone calls, letters, faxes and e-mails. College staff will tabulate accumulated points for each contact.

At the Leadership Day dinner on May 25, the College will present a Key Contact of the Year award to the member who has accumulated the most points. In addition, the top 10 runners-up will receive Key Contact Special Recognition Awards.

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