Ohio medicine : journal of the Ohio State Medical Association

686 Pages·1991·56.6 MB·English

by  Ohio State Medical Association

THE FRANCIS A. COUNTWAY LlBPcARY OF MEDICINE
Harvard MedicalLibrary-Boston Medicallibrary
Digitized by the Internet Archive
2016
in
https://archive.org/details/ohiomedicinejour8719ohio

OHIO
Medicine
J0L[RNAL of the OHIO STATE MEDICAL ASSOCIATION
VOL. 87, NO. 1 JANUARY 1991
• Keeping the “Buy Right ” Plan • Major Issues Facing
Dream Alive for Health Care Medicine in 1991
Page 7 Page 19 Page 35
. . . . . . . . .
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Doctors
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Good Look
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OSMA’s
AfeWESTj^MBER
.Benefit...
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Li ' 1 —\
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Featuring: Competitive rates
Guaranteed Acceptance
Available to members, their families, and
office staff
Average two week turnaround on claims
$1,000 calendar year maximum per insured
$50 Deductible/$100 Family
100% Diagnostic/X Ray
80% Minor Restoration
50% Major Restoration
50% Orthodontia
Formore information and toapplyforcoverage, contact
yourOSMA Benefit representative atAmerican Physicians
Lifetoll free, 1-800-742-1275.
OSMA Dental available through American Physicians Life,
the OSMA’s life and health carrier, committed to maintaining
thefinest benefitsfor members at the lowest possible price.
BatesDrive,PO Box281
Pickerington,Ohio43147
[phone]
1-800-742-1275
Contents
OHIO
Medicine
/ January 1991
Vol. 87 No. 1
Departments
25 COVER STORY:
Rural communities are
3
Presidential scrambling to recruit
Perspectives physicians. Monroe
County thinks foreign
5 Auxiliary Page medical graduates may
be the answer to the
21 Commentary doctor shortage.
38 fr'c
Obituaries Loss Awareness: I ^V^; /
BQST 'jE
42 Effective doctor-
Continuing MecM^Scene
patient
Medical Education
relationships serve
44 as a major element 10 Closer look at
Classified
in reducing migrating “snow
Advertising
malpractice suits.
birds.”
47
Journal Advertisers Legislation: What 11 Book reveals
48 are the major humorous incidents
Medical Aids
issues facing in physicians’ lives.
medicine in 1991?
12
Substance-sniffing
Peer Review: Peer deaths on the rise.
Articles
Review is shifting 13 OSMA
produces
emphasis from
its
sports videotapes.
Second Opinion: case-by-case
Keeping the dream assessments to the 16 NASA working
alive. larger-picture goal with CWRU to
of education.
benefit orthopedics.
Reimbursement:
Cleveland initiates Research: New 17 Physician
“buy right” plan drugs for AIDS Effectiveness
for health care. treatment; heart Program plans to
attack risk- hire full-time
28 OSMA: Changing reduction; treating director.
directions in the addicted veterans;
— ISSN 0892-2454
’90s Part II study on infections. USPS 405-200
January 1991 1
EDITORIAL STAFF
Executive Director
Herbert E. Gillen
Director, DepartmentofCommunications
Carol Wright Mullinax
Executive Editor
Karen S. Edwards
Associate Editor
Karen Kirk
Production Assistant
Nancy Hacker
JOURNAL ADVISORY BOARD
Outstanding
Richard Reiling, MD, Chair
Dayton, Ohio
MD Obstetrics-Gynecology
Charles L. Heaton,
Cincinnati, Ohio
William Marshall, MD practice opportunity!
J.
Dayton, Ohio
Richard Nowak, MD
Cleveland, Ohio
MD
James Ravin, Located on Ohio's North coast with the best
Toledo, Ohio
William B. Rogers, MD of four seasons in a city with excellent
Cuyahoga Falls, Ohio
schools and cultural attractions.
OSMA OFFICERS
President
MD
John A. Devany,
President-Elect
Joseph Sudimack, Jr., MD 600-f bed tertiary care medical center.
Immediate Past PresidenMtD Comprehensive services provided in a growing
William Marshall,
Secretary-TJr.easurer OB/GYN department. Excellent clinical and
MD
John F. Kroner, Jr., diagnostic facilities. Very competitive financial
ADVERTISING package available for qualified BE/BC physician.
George R. Quigley
4015 Executive Park Dr.
Suite 304 Interested individuals may send CV
Cincinnati, Ohio 45241
[phone] in confidence to:
PHARMACEUTICAL
ADVERTISING Ellen F. Yunker
Terry Gladman Manager, Physician Recruitment
Lifetime Learning
15 W 700 North Frontage Rd. St. Vincent Medical Center
Hinsdale, IL 60521 2213 Cherry Street
[phone] Toledo, OH 43608-2691
A&ddRerpersisntAlRleqCuoersrtes(upnolnedssenocteh,erwAidsderenostsedC)h:aEnxgeec,- Or call
utiveEditor, OHIOMedicine, 1500LakeShore [phone]
Drive, Columbus, Ohio 43204-3824. Phone:
[phone]..
PublishedmonthlyunderthedirectionofTheCoun-
cilforandbymembersofOHIOMedicine, 1500Lake
ShoreDrive, Columbus, Ohio43204-3824, ascientific
society,nonprofitorganization,withadefinitemember-
shipforscientificandeducational purposes.
1991Subscription:S25 peryear.
Sendaddresschangesto;OHIOMedicine,1500Lake
ShoreDrive, Columbus, Ohio43204-3824.
SecondClassPostagepaidatColumbus,Ohioandat
additionalmailingoffices.
OHIOMedicinedoesnotassumeresponsibilityforopi-
nionsexpressedbytheessayistsorinthecolumn "Se-
condOpinion."Advertisersmustconformtopoliciesand
regulationsestablishedbyTheCounciloftheOhioState
MedicalAssociation.
2 OHIO Medicine
—
Presidential Perspectives
New
Happy
Ifear!
L
et’s start the New Year with Camardese, MD, who recently won
a positive note. It seems we the case on Medicare billing of
have to look long and hard office laboratory procedures. The
for something to be happy about Federal Appeals Court has refused
after that budget-reconciliation to reverse the decision of the lower
—
fiasco but small steps are court. Nino has also been
helpful. nominated for the Benjamin Rush
Your efforts and contacts with award of the AMA. There is
Congres—s got the anti-hassle bill certainly no question that he is
passed the section regarding willing to put his money where his
publicizing the “screens” did not mouth is, and there is no question
pass. Agree with the passing or of his devotion to God, country
not, the anti- and medicine.
competitive It is encouraging to see that the
reason used governor’s Task Force has come up
to reject it with a plan (Access Ohio) for
By John A. has some financing the health-care needs of
MD logic. Ohioans. The plan bears striking
Devany, You really congruity with Health Access
did it in a America, but even more
storm of interesting, I thought, were Gov.
President of 50,000 letters Celeste’s remarks in accepting the
the OSMA that report. He stated that this problem
descended on cannot be solved by state action
8
Washington, alone, but must be a conjoint
protesting effort of business, the —
^ and pointing professionals and government
si wiA out the that from a man who fancies
senselessness, himself to be a political
impracticality and increased philosopher. That is as realistic
expense of the proposed office thinking as we’ll get.
laboratory regulations. The whole The process of dialogue takes
proposal has been withdrawn effort. Many of the provisions of
because you let our representatives Health Access America have been
know, in no uncertain terms, that introduced in Congress and will be
it just wouldn’t work. Even the back next session. Bill 3042
sponsor of the initial legislation (Coburn, R-Maine),
got on the bandwagon, stating that “Comprehensive Health-Care Act
the proposal was fantastic overkill of 1990,” contains a variety of
—
to the problem (actually directed at provisions payment for
Pap smear interpretation). It will physicians and hospitals, favorable
be at least September before the tax treatment of health insurance
new regulations are published. Stay experts, long-term care insurance,
tuned. uninsurable risk pools, Medicaid
Congratulations, also, to Nino standardization expansion and
January 1991 3
Presidential Perspectives
medical liability reform (all are in 1. Does a physician generate The FTC is reported to be
Health Access America). profit by bringing in an evaluating office space contracts
The medical liability provisions economically favorable patient between hospitals and doctors to
unfortunately do not have any mix? see what “sweetheart’’ provisions
effect on our problem in Ohio 2. Does individual utilization amount to rebates. So check the
with the statute of limitations, but review illustrate financi—al and/or market, check with your attorney
they do put great emphasis on the quality of care issues which and remember that there are
development of treatment practice cause the hospital to lose money? wolves out in those woods.
Am
parameters (TPGs). I alone All of the bowing and scraping There is good reason in today’s
when I get a slight chill listening that I see with hospitals courting climate to feel that we have lost
to talk of specifying appropriate- physicians with physician staff the ability to affect our own
inappropriate and permissive counselors who function as a destiny, so we must cut the best
methods of evaluation and concierge is as phony as a $3 bill. deal for ourselves. This is no time
treatmen—t? All of us want to be “Everything is just so great at to go it alone. The next two to five
current but think of some of Better Samaritan Hospital!’’ years will demand an intelligent
the ideas that were current 25 Physicians must be aware that look at professional militancy.
years ago (e.g. carotid body there is a Medicare regulation The picture is not all dark.
surgery). However, the against rebates between physicians When we stand together as
anesthesiologists and the OB-GYN and between hospitals and doctors, we can be heard! OSMA
group has demonstrated that physicians. (We are not providers.)
—
protocols do have a place and
they successfully affected their
malpractice rates by following
them. The idea being that TPGs ATTENTION RESIDENTS
establish a rebillable prescription
that the services prescribed by the AND
TPGs are the appropriate standard
of care. Peer review organizations MEDICAL STUDENTS!
could use these parameters in
making payment determination
(screens again). OHIOMedicineinvites you to enteroursecond "Medicai
Most of you have heard me rave Writing Contest."
about the persistent
The competition is open onlyto Ohio medical residents and
d—eprofessionalization of medicine students. A plaque and a $250 prizewill be awarded to both a
which can be attributed to the resident and a medicai studentwho submitthe most
government, notably the Federal outstanding scientific paperasjudged by a distinguished
Trade Commission, and to the panei of medicai experts.
insurance industry. But let us not
let our friends in hospital The papers should be submitted between nowand March 1,
administration off the hook too 1991. Winners will beannounced and prizes awarded atthe
early. We must each rem—ember that 1991 OSMA Annuai Meeting in Columbus, Ohio.
dhoosnp’ittaflosrgaerteita. bWuesinneosws heatrheayt MedTihceinwei.nning entrieswill also be published in OHIO
meetings of “economic
credentialling” becoming a basis Aii entries should be no morethan 10typed, double-spaced
for hospital privileges. A recent pages in iength, and shouid be sentto:
study reported in AMNews says
that a review of how a physician OHIO Medicine
uses a hospital’s service can affect "Medical Writing Contest"
the hospital’s bottom line is now 1500 Lake Shore Drive
in place. As Ray Gifford, MD, has Columbus, Ohio 43204-3824
pointed out, that concept has two
different factors:
4 OHIO Medicine