Clark County Medical Society

County Line

Newsletter XXIX           June 2002

 

Contents

Nevada Chief Justice changed by humanitarian experience in Haiti

Messenger Model IPA Guidelines

President’s Message

Applicants To Go Before Credentialing Committee

New Members for May 2002

Candidate Profiles

John A. Ellerton, MD, CM FACP – Candidate for Assembly District 5

            Joe Hardy, MD – Candidate for Assembly District 20

            R. Garn Mabey, MD – Candidate for Assembly District 2

Rebuttal: "A Second Opinion"

2002 Election Results

CME CALENDAR

CLARK COUNTY HEALTH DISTRICT DISEASE STATISTICS APRIL 2002

Calendar of Events

Classifieds

 

 

Nevada Chief Justice changed by humanitarian experience in Haiti

By Jeff Rogers for the Shearing-Westfield Eye Institute

            Nevada Supreme Court Chief Justice Bill Maupin returned to Las Vegas forever changed after taking part in a 10-day humanitarian mission to Haiti. During the mission, which required him to work 8 to 10 hours a day and live in extremely close quarters with more than half a dozen doctors and medical professionals in the isolated mountain village of Lascahobas, Justice Maupin was deeply touched by the people, the friendships he established, and a new admiration for the medical profession.

            Although he comes from a long line of physicians and had considered a medical career, Justice Maupin broke with tradition as a young man to pursue law after hearing an attorney deliver an inspired speech about the legal profession. Now, after years of representing doctors and hospitals before serving as a judge, Justice Maupin has a new appreciation for doctors, nurses, and medical technicians after working with them in incredibly unfavorable conditions.

            "I believe this mission exemplifies what American doctors do for people every day throughout the world," Justice Maupin said.

            And although he said nothing anyone told him to expect could have prepared him for the emotional, physical, and psychological events of the trip, he will never forget the positive and powerful impact American medical professionals, including several from Las Vegas, made in the course of a few days.

            "Hundreds of people who were blind or visually impaired would arrive, be seen by these hardworking doctors, and when they would leave … they could see. It was a miracle," Justice Maupin said. "I am so fortunate that I was able to play a small part in this majestic effort. I consider it one of the most important things I have ever gotten to do."

            Justice Maupin had asked his friend Dr. Kenneth Westfield, medical director of the Shearing-Westfield Eye Institute, if he could help by joining the doctor on one of the missions several years ago. This was the first year Dr. Westfield agreed to allow Justice Maupin to join himself, Dr. Tyree Carr of the Nevada Institute of Ophthalmology, and Frances Gonzales, RN, of the Tenaya Surgical Center, to treat debilitating eye conditions such as cataracts and glaucoma in the impoverished mountain village of Lascahobas. Dr. Westfield's previous reluctance to bring Justice Maupin along was only tied to the fact that Justice Maupin is his friend and that the experience has often proved too demanding for people in the medical profession, let alone a "civilian."

            "Dr. Westfield has been a close friend for years," Justice Maupin said. "We are now a lot more than that; we're a family."

            According to Dr. Westfield, Justice Maupin quickly proved he was up to the task. He checked the intraocular pressure for well over 600 people and stood in on a few of the 70 surgeries performed in over four days. Justice Maupin adds that while he had never poked anything in a person's eye before, he eventually became comfortable with performing the procedure. In fact, according to Justice Maupin, it was the human interaction between the team and their patients that made the deepest impression on him.

            "When a language barrier prevents you from understanding why a blind, elderly woman suddenly becomes terrified, you realize how much of the medical profession is about true compassion," Justice Maupin said. "Then you learn that the woman is afraid the doctors are going to take away her eyes, and it hits you. Some of these people have never been seen by a doctor before. In my opinion, every medical person who was there - from Las Vegas, Washington, D.C., and New York - were the best with the best equipment in the world. They did the impossible, treating almost 700 people who would never have received this type of medical attention if it was not for their efforts."

            Armed with only two medical suites of equipment brought with them from the United States and working in a hospital that Justice Maupin describes as new, but not modern (defined as "new" 100 years ago), they worked diligently to see as many people as possible while calming the understandable anxieties. All too common were the reminders of how impoverished and isolated the people of Lascahobas are: a boy with a juvenile cataract, one of several children his family picked to make the trip, which Justice Maupin will never forget.

            "It is still an emotional experience when I think of the faces, their desperation to receive help, yet visible fear of the unknown," Justice Maupin said. "And then you realize doctors deal with this every day - not just in Haiti, but even here in America … they share their professionalism and compassion with all of us."

            Five hundred pairs of eyeglasses. Twenty-five hundred prescriptions. A handful of medical personnel. And one Nevada Supreme Court Chief Justice who followed the advice of the people he bonded with during the mission: wait a few weeks before you decide whether or not to return next year. A week ago, Justice Maupin called Dr. Westfield to tell him that he would not miss it for the world.

            The Shearing-Westfield Eye Institute has already begun collecting eyeglasses for next year's mission. To donate eyeglasses, contact Sandi Zenhari, Practice Development Coordinator, at 702-362-3937, ext. 238.

 

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Messenger Model IPA Guidelines

By Weldon (Don) Havins, MD, Esq and Kelly Testolin, MBA, Esq

 

            A group of Las Vegas' OBGYNs and a large number of Pediatricians have recently begun efforts to form a "Messenger Model" IPA.  Articles of Incorporation have been filed with the Secretary of State for the "Southern Nevada Maternal-Child Independent Practice Association, Nowins, Ltd., a Professional Corporation."  Messenger Model IPAs are not new to Nevada.  There is one in Carson City and two in Reno.  All three are said to be functioning well in the Northern Nevada environment. 

            Because other specialties and physician groups may also consider forming or participating in similar model IPAs, a few words about the rules under which Messenger Model IPAs function may be prudent.  One of the few available, detailed definitions of a "messenger model" IPA was provided by the U.S. Department of Justice, Antitrust Division, in a stipulated judgment in the case of United States v. Health Care Partners, Inc., reported in the Federal Register, Vol. 60, No. 192, Wednesday October 4, 1995 at page 52014.  The federal register may be found using, among others, the findlaw web site at:  www.findlaw.com   Look under "Laws: Cases and Codes", click on "Federal Register" under U.S. Federal Laws, check the 1995 box (Volume 60) and enter the search terms "messenger model" to find the above named case for the complete discussion.

            The FTC and DOJ state that "messenger model" means the use of an agent or third party to convey to payers any information obtained from individual providers about the prices or other competitive terms and conditions each provider is willing to accept from payers, and to convey to providers any contract offer made by a payer, where each provider makes a separate, independent and unilateral decision to accept or reject a payer's offer.  The information on prices or other competitive terms and conditions conveyed to payers is obtained separately from each individual provider, and the agent or third party does not negotiate collectively for the providers, disseminate to any provider the agent's or third party's or any other provider's views or intentions as to the proposal, or otherwise serve to facilitate any agreement among providers on prices or other competitive terms and conditions.

            The agent or third party (messenger), acting consistently with the above rules, may:

(1) Convey to a provider objective information about proposed contract terms, including comparisons with terms offered by other payers;

(2) solicit clarifications from a payer of proposed contract terms, or engage in discussions with a payer regarding contract terms other than prices and other competitive terms and conditions, except that the agent or third party

(a) must tell the payer that the payer may refuse to respond or may terminate discussions at any time and

(b) may not communicate to the providers regarding, or comment on, the payer's refusal to offer a clarification or derision not to enter into or to terminate discussions except to providers who requested the clarification;

(3) convey to a provider any response made by a payer to information conveyed or clarifications sought;

(4) convey to a payer the acceptance or rejection by a provider of any contract offer made by the payer, and

(5) upon the written request of a payer, provide the individual response, information, or views of each provider in the IPA concerning any contract offer made by such payer.

            Additionally, the agent or third party must communicate each contract offer made by a payer unless the offer is the payer's first offer and lacks material terms such that it could not be considered a bona fide offer, or the agent or third party applies preexisting objective criteria, not involving prices or other competitive terms and conditions in a nondiscriminatory manner (for example, refusing to convey offers of payers whose plans do not cover a certain minimum number of people or offers made after the agent or messenger has conveyed a stated maximum number of offers for a given time period).

            The critical feature of a properly devised and operated messenger model is that individual providers make their own separate decisions about whether to accept or reject a purchaser's proposal, independent of other physicians' decisions and without any influence by the messenger.  The messenger may not coordinate individual providers' responses to a particular proposal, disseminate to physicians the messenger's or other physicians' views or intentions concerning the proposal, act as an agent for collective negotiation or agreement, or otherwise serve to facilitate collusive behavior.  The proper role of the messenger is simply to facilitate the transfer of information between purchasers of physicians' services and individual physicians or physician group practices and not to coordinate or otherwise influence the physicians' decision-making process.  For example, it would be a violation of federal law for the messenger to select a fee for a particular procedure from a range of fees previously authorized by an individual physician, or to convey collective price offers from physicians to purchasers, or to negotiate collective agreements with purchasers on behalf of physicians.

            The messenger may convey to a physician objective or empirical information about proposed contract terms, convey to a purchaser any individual physician's acceptance or rejection of a contract offer, canvass member physicians for the rates at which each would be willing to contract even before a purchaser's offer is made, and charge a reasonable, non-discriminatory fee for the messenger's services.

            In short, a messenger model IPA is not a vehicle to avoid the prohibitions of the Sherman Act, the Clayton Act, or the FTC Act.  Collusive acts, conspiracy to restrain trade, or actions such as boycotts are violations of federal law.

            Two recent examples of impermissible messenger model actions, one in Tampa, Florida, one in Delaware, follow.  A group of general and vascular surgeons in Tampa, Florida, were found by the Department of Justice (DOJ) to have participated in illegal joint negotiations and boycotts in January 1999.  A group of orthopedic surgeons in Delaware suffered the same fate for similar actions.  

            In Tampa, 29 general and vascular surgeons formed the Federation of Certified Surgeons and Specialists, Inc. (Federation). The member physicians made up the majority of general and vascular surgeons with operating privileges in the Tampa area hospitals.  The DOJ charged that the Federation was formed to obtain higher fees for their services from managed care plans.  The Federation's agent allegedly approached health plans to negotiate higher fees.  The agent informed the plans that the physicians would terminate their contracts and refuse to participate in the plan's network unless the Federation's terms were accepted.  In at least one instance, the agent was successful in obtaining higher fees for the Federation physicians after 28 of them had terminated their contracts with the managed care plan.

The DOJ found that the messenger's activities constituted illegal joint negotiations, and illegal boycotts or threats of boycotts.  Joel Klein, Assistant Attorney General for the DOJ's Antitrust Division stated, we are resolved "to stop illegal joint negotiating and boycotts by physicians. We will take action to stop illegal boycotts that ultimately increase the prices consumers pay for health care."  The Federation and its participants agreed to cease the illegal activities and, fortunately, were not required to pay any fees or fines.

            The messenger agent for the Delaware Federation of Physicians and Dentists attempted to negotiate fees with Blue Cross and Blue Shield of Delaware (Blue Cross). When Blue Cross declined to deal with the agent, the Delaware Federation increased its efforts to persuade doctors to deal with Blue Cross only through the Delaware Federation organization.  Ultimately all member orthopedists terminated their contracts with Blue Cross. The DOJ charged that the Delaware Federation misused a "messenger" arrangement to facilitate illegal collusion by doctors to maintain high fee levels.

            In both of these cases, the DOJ admitted that a "messenger-model" arrangement, when implemented with adequate safeguards, may aid in the transmission of information between health insurance plans and doctors.  The streamlining of transmission of information between plans and providers may ultimately benefit consumers, the DOJ stated.  However, a "messenger-model" may not be misused to strengthen the bargaining power of those it serves, and its activities may not rise to the level of illegal joint activity or boycotts.

            In 1996, the DOJ and FTC issued Antitrust Guidelines for physician networks utilizing messengers; specifically:

(1) Messenger of the network, not affiliated with any participant, obtains from each participant a fee schedule or conversion factor that represents the minimum payment that participant will accept from a payor. The Messenger is authorized to contract on the participants' behalf with payors offering prices at this level or better. The Messenger does not negotiate pricing terms with the payor and does not share pricing information among competing participants. Price offers that do not meet the authorized fee are conveyed to the individual participant.

(2) The same as (1), above, with the added feature that the Messenger is authorized, for a specified time, to bind the participant to any contract offers with prices equal to or better than those in a contract that the participant has already approved.

(3) The same as (1), above, except that, in order to assist payors in developing contract offers, the Messenger takes the fee authorizations of the various participants and develops a schedule that can be presented to a payor showing the percentages of participants in the network who have authorized contracts at various price levels.

The Guidelines warn against the sharing of fee-related information among the participants. The key issue in any "messenger-model" arrangement is whether the arrangement creates or facilitates an agreement among competitors on prices or price-related terms.  The Guidelines also present the following example of a "messenger-model" function that the DOJ and FTC view as a "per se unlawful price agreement:

            The agent is hired to negotiate with payors on behalf of the participants. The agent does not disclose to the payor the prices the participants are willing to accept, but attempts to obtain the best possible prices for all of the participants. The resulting contract offer is then relayed to each participant for acceptance or rejection.

            The "messenger-model" approach is sometimes used as a transition model, as IPA's move toward capitation and other risk-sharing arrangements.  An IPA whose participants share financial risk has a great deal more flexibility under the DOJ and FTC Guidelines for sharing of information and negotiating, as a group, with payors.  However, such IPA's usually face much more significant size limitations (e.g, the number of participating providers) than do "messenger-model" IPAS.  Many mature IPAs continue as "messenger-model" entities, finding this model produces acceptable results.

            Given the DOJ's and FTC's active scrutiny of "messenger-model" type arrangements, it is crucial that messenger model IPAs comply with the guidelines.  It appears the DOJ will actively enforce antitrust laws when "messenger-model" activities are used, or are perceived to be used, as a shield for unlawful collusive behavior.

 

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President’s Message

By Raj Chanderraj, M.D., 2001-2002 CCMS President

The Malpractice Liability Coverage affordability crisis is growing and has come to directly affect patient care. Although the Obstetricians and Gynecologists are in the forefront, we will soon see the Trauma Center physicians and the Orthopedicians getting affected. The governor is on our side and is constantly trying to help us in our hour of need. Unfortunately, many in the physician community are not aware of his actions and thoughts and are very critical of him. Almost all of us who have been actively involved in the goings on have been very impressed with his sincerity. The Nevada State Medical Association, in recognition of his efforts, has decided to give him the Nick Horn Award. This is an award honoring a citizen of Nevada who has been the most influential in furthering the cause of medicine and physicians.

The past year has been very turbulent for physicians. There are several physicians whose lives have been affected adversely by the present crises. We empathize and feel for them and their families. But out of this tragedy, a sense of unity among the physicians has emerged and hopefully will gain momentum and gather strength that will enable us to achieve our goals with Malpractice Liability, Reimbursement, and Health Care to our patients. I think the present situation should be used as a catalyst for all of us to shred our reluctance to participate in the democratic process of our community and take an active role in becoming the architects of our own destiny. There are still significant numbers of us who are constantly critical of the leadership. I ask of them to help if you can and contribute to our growth by participating in Organized Medicine, rather than being a hindrance.

My term as the President is complete. I hope I lived up to your expectations. I am sure my successor, Dr. Evins, will continue to lead us through these turbulent times. I thank you all, especially the board members, committee chairs and members, for your contributions to help me fulfill my responsibilities. I am grateful for Dr. Havins' valuable assistance and guidance. I deeply appreciate the assistance of Dot … and Deborah … at the Medical Society, without whose help my ability to function would have been severely limited.

Good Luck and Best Wishes.

 

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Applicants To Go Before Credentialing Committee

If you have any pertinent information about the following membership candidates, please contact:

Clark County Medical Society, 2590 E. Russell Rd., Las Vegas, NV 89120

 

Paul Casey, MD                       Ophthalmology

Carlos W. DeAraujo, MD        Oncology/ Hematology

 

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Congratulations and Welcome to the Clark County Medical Society New Members for May 2002

Syed Akbarullah, MD, Internal Medicine, 7200 Cathedral Rock #140, Las Vegas, NV 89128

Marsha Matsunaga-Kirgan, MD, Ob-Gyn, 2040 W. Charleston Blvd. #200, Las Vegas, NV 89102

Lisa Roberts, MD, Ob-Gyn, 3841 W. Charleston Blvd., Las Vegas, NV 89102

Jerome Ziarko, DO, Family Practice, 4415 W. Flamingo Rd., Las Vegas, NV 89103

 

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Candidate Profiles

John A. Ellerton, MD, CM FACP – Candidate for Assembly District 5

HOPEFULLY AWAKENED

The significance of March 4th remains unclear in the minds of many physicians in Nevada.  It should not.  March 4th exposed the panoply of opportunities and hope that we are, for a brief moment, offered.  We must, in concert, act to grasp these opportunities, nurture them and bring them to fruition. 

What is he talking about?

This was the first trip for many physicians to the legislative hearing rooms and their first opportunity to observe governmental processes in action.  I hope they do not forget these lessons and will answer the call during the legislative session.

But most of all this is our opportunity to develop, advocate, and participate in fundamental reforms in the health care system.  Many of the solutions needed will have to be national, but the ideas, the laboratories to test them; the nidus for development can be our efforts in the state.

Tort reform goes without saying.  But this reform does not stand alone.  It must be part of a bigger effort to make our health care system better.  Insurance reform, both in relation to malpractice and health insurers, must be pursued.  Medical error reporting programs must be developed, and advocated, by the medical community.  Medicaid reform, ideas to improve nursing education and alleviate the shortage, and improvements in public and mental health programs, must all be part of our efforts.

These times have created a special opportunity for physicians to work together.  This cooperation is necessary for and essential to the success of our effort. 

While we work on our specific concerns, we must not be ignorant of the general problems of our local area, many of which are related to the continuing population influx.  In fact, I believe that many of our problems and our patients' problems are one of the effects of this sustained growth.  Physicians are impacted by much of what is accomplished in the legislature.  Once more, we are presented with an opportunity; to be involved in the political system as it affects everyone's lives.  We must not abandon our role in keeping Nevada a great place to live.

Ours is a privileged position.  We must use that privilege to maintain the joy that is medicine. We must use that privilege to advocate for our patients and for our society, to ensure the best health care for all citizens. 

Hopefully we are awakened to the process.  Hopefully we are awakened to the opportunities.  Hopefully we are awakened.

 

Contributions:

John Ellerton for State Assembly

P.O. Box 81255

Las Vegas, NV 89180-1255

 

Joe Hardy, MD – Candidate for Assembly District 20

IT'S A RACE AND I'M RUNNING

            Assembly District 20 is newly created by reapportionment. It consists of the River Cities from Mesquite to Laughlin including Logandale, Overton, Searchlight and Boulder City with small areas of Henderson and Las Vegas. I am running as a Republican with the main plank of my platform being access to medical care.

            I was elected to the City Council of Boulder City 3 years ago. I currently serve as the mayor pro tem of Boulder City and the Vice-president of the Southern Nevada Regional Planning Coalition. Likewise, I serve as the Boulder City Elected Official assigned as a member of the Board of Directors of the Clark County Health District (CCHD). I have been a driving force to encourage the CCHD to be involved with the resolution of our critical malpractice coverage situation. I endorse the California MICRA Act of 1975 provisions.

            As physicians, we are not alone in this insurance dilemma. Contractors and business owners are our natural allies for tort reform. The insurance companies themselves are worried as their claims have increased without the premiums to support them. Our litigious society has discovered the legal lottery. Jury awards need to be reigned in by regulation. Parameters that will help the injured without putting people at risk of losing their physicians are urgently needed.

            As physicians, we have been trained to ferret out the best way to solve problems. Feeling that others will obviously agree with us, we give them the option to do what we suggest. We are taken aback when they choose a different course.

            Right now, we are in a battle of words and opinions that won't be won just because we are right. We must play the "political game." We must ask each and every candidate or incumbent specifically on each and every point how they will vote. We, as physicians, must tell them our opinion and why. We must either sway them to commit to vote for global and specific tort reform or tell them we will campaign with money and man-hours for someone who will. We must become individually and collectively lobbyists. We then must tell our patients to do the same by putting in their hands letters to be sent or phone numbers to call.

            This legislative session is critical to accomplish all that we can in the way of tort reform. People are on the side of the doctors. We must focus on the reality that this is an issue of providing access to care, not to protect the doctors' alleged lifestyle. We lament the woes of mothers, children and trauma patients. Our hands, trained to heal and to comfort, are shackled with the financial fetters of insurance payments.

            As a native Nevada family physician with 4 children out of college, and 4 still in the process of high school and further education, I have a goal to be elected with all the support of the medical community. Campaigns are costly and the four months without income from my practice will require a huge financial sacrifice. Please contribute quickly and generously. Thank you.

 

Contributions:

Elect Joe Hardy

1357 Sunrise Circle

Boulder City, NV 89005

 

R. Garn Mabey, MD – Candidate for Assembly District 2

            When I first announced that I was running for the Nevada Assembly, people would ask me why. The main reason is that I truly feel I can make a difference and that I represent the ideals and values of those people who live in Assembly District 2.

            I was fortunate to have had a great childhood. My father was a family physician in a small town in Idaho. My mother was his nurse. My Grandfather Mabey was also a physician, as were my two uncles. Grandpa Mabey was one of those men who everyone admired, respected and loved. He was the town doctor, the bishop in the church, and its mayor. He was one of my heroes.

            One of my other heroes was a neighbor. His name was Melvin Hammond. He served in the Idaho State Legislature for years. I was close to his family since his daughters were my age. He left a lasting impression on me concerning the importance of public service.

            Since our city was small, I had many opportunities to shake hands with the Governor, U.S. Senators and Representatives, and local leaders. I guess it was sometime when I was a teenager that I caught the political bug. It has lain dormant for all these years.

            After high school, I attended college, which was interrupted by a two-year mission for my church to Spain. After my mission, I resumed my education, got married, and graduated BYU. I attended Jefferson Medical College in Philadelphia and graduated in 1985. I completed a residency in Ob/Gyn here in Las Vegas at University Medical Center in 1989. I have been in private, solo practice since then. My wife and I have been married for 22 years and we have five children.

            I feel confident that I will win my race. Politics is harder than I thought. I feel like I am in my residency again - the days are long and there is always something to do. I have already knocked on many of the doors of those who live in Assembly District 2. Asking for political donations is still awkward. Still, I am enjoying the experience and it truly is fun.

            Therefore, what will I do when elected? I certainly will do my best to make medical tort reform a reality. It will not be easy. Nevertheless, without it, many physicians will leave. As I have walked and talked with people, I sense that the public is supportive of physicians like never before. The attitude that we are a group of rich people just watching out for ourselves is fading. In my opinion, there will be meaningful tort reform.

            There will be other important issues. I personally hate the way the Medicaid system works now and I will do my best to change it. Taxes will be discussed. As our state grows, so does our budget. Our state needs to provide basic functions, but I am not one who enjoys paying taxes so my vote will be to keep it to a bare minimum.

            I anticipate a tough primary but I will prevail and next year at this time, you can call me in Carson City. Any help will be greatly appreciated.

 

Contributions:

R. Garn Mabey, M.D.

2881 N. Tenaya Way

Las Vegas, NV 89128

 

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Rebuttal: "A Second Opinion"

By Benjamin H. Venger, MD, FACS, The Western Regional Center for Brain and Spine Surgery 

 

Dear Mr. Myers,

            We of the medical community appreciate your recent guest column in the Clark County Medical Society County Line.  Your thoughts on the Malpractice Insurance Crisis, which threatens every resident of Southern Nevada, are certainly with merit.  I had not returned to Southern Nevada to practice medicine when the Nevada Medical Liability Insurance Company (NMLIC) was formed.  Yet they and subsequently St. Paul Insurance Company provided my medical liability coverage.   St. Paul will continue to cover me until August of this year.  Since Neurosurgery is considered a "high risk speciality," I now tread the murky waters of seeking a high priced solution in order to continue to practice my trade.

 

The Problem

            I cannot address the underwriting policies of Nevada's current or past Medical Liability Carriers, nor their business practices.  Unfortunately, physicians did not play a role in such decisions.  It is however too neither late nor prudent, to try and reconstruct the scenario that has resulted in the current problem.  Simply stated, good caring physicians of Southern Nevada cannot buy malpractice insurance coverage reasonably and quickly enough to continue to remain in practice.

            Yes, an exodus of physicians will occur, while others are forced into early retirement.  Unlike the laws of supply and demand, the fewer remaining doctors cannot raise their fees to compensate for the hypothetically increased demand.  In reality, we face regular reductions in our compensation.  That, coupled with the increased cost of our overhead (part of which now includes increased Malpractice insurance rates, and an additional lump sum payment for tail coverage), has made it more difficult for the remaining doctors to keep their doors open.  Currently, the situation has also made the recruiting of new talented physicians to our community more complicated, and in some cases impossible, to meet the demands of one of the fastest growing regions in our nation.

 

The Medical-Legal Screening Panel

            What about frivolous lawsuits?  No one disputes that they exist, and add cost to both the medical liability milieu and the courts.  Recent articles in the newspaper have suggested that Malpractice insurance carriers have not settled cases in a timely manner before trial, and then incur a greater award being levied by jury.  Who determines what is real malpractice versus non-meritorious allegations?  Perhaps when NMILC existed, the medical legal screening panel (comprised of three physicians and three lawyers, all with an equal vote) made decisions that carried some weight within the judicial system.  Weakened by legal challenge, the panel is now merely a formality on the road to jury trial.

            Even the composition of the panel remains suspect.  Can a dermatologist, pediatrician, or family physician determine if some error in judgment was made addressing complex questions of management in dissimilar fields (such as Neurosurgery)?  Although a doctor can go to the medical library and research a topic, should that suffice for a residency in a specific specialty and years of clinical practice? 

            What really is the role of the attorneys on the panel?  Many of the "Medical Malpractice" weekend courses and seminars I see advertised in the legal journals and like publications barely scratch the surface of the rapidly advancing body of medical knowledge. The majority of the time spent in panel deliberations of malpractice is not questions of error, timing of intervention, etc.  Rather, it is spent trying to explain the medical issues in layman terms to the attorneys assigned to the case.  The cases become backlogged.  Some panels have had to set a time limit to decide whether a case has merit or not.  Is this fair to the accused physician or plaintiff?  What if juries had only a certain time to render a verdict?

            By the way, it would be interesting if I could serve on many of the panels and oversight committees of the Nevada Bar. As a novice to the legal field, I would find the "education" fascinating.  Of course, not being formally trained in or practicing law, I am relatively unfamiliar with the complexities of the Nevada statues, procedural rules, and determining if potential legal malpractice has occurred. Despite this, and like the current medical legal screening panel, should not my vote in judging your legal colleagues carry the same weight (and consequences), as those attorneys whose education, experience, and credentials render them true judicial experts? 

            To what degree should my amateur input weigh in assessing allegations of legal negligence, when a lawyer's reputation, future practice and malpractice premium, hang in the balance?  Perhaps the role of the lawyers on the medical legal screening panel could be, to decide what sanctions or fines should be assessed against attorneys who file frivolous lawsuits, or just "sue everybody" without taking the time, effort, or money, to determine who is at fault.

 

Dr. Rotten Apple

            I am in a unique position to address the problem of Dr. Rotten Apple.  Although not a Neurosurgeon, Dr. Rotten Apple practiced spine surgery, as do my Neurosurgical collegues and I.  Dr. Rotten Apple began as a doctor in training for a large group of spine surgeons in Southern California.  Despite the wealth of competent and experienced spine practitioners in Southern Nevada, our own State Industrial Insurance System (many with the blessing of the injured workers' own legal counsel) began a stream of patients from Las Vegas to their clinics and hospitals in Los Angeles.  Concurrently, state supported funds, which could have been reinvested in Southern Nevada, also exited from our community with them. 

            Dr. Rotten Apple and colleagues then opened a "branch office" in Las Vegas, not surprisingly across the street from the headquarters of State Industrial Insurance System.   Amazingly none of these doctors actually lived or performed surgery in Southern Nevada, nor actively sought referrals from local physicians.  Yet, they became the highest paid medical group by our state's workman compensation system.  How could this have happened without referrals from the local physicians or hospitals? 

            The answer is through referrals by some attorneys who shared Dr. Rotten Apple's vision of financial reward.  Through frequent poorly planned surgeries, numerous repeat procedures for dubious indications or for complications, and of course through inflated medical charges, Dr. Rotten Apple's compensation and that of his legal supporters grew. He soon thereafter left California and began to practice in our community full time.

            The problem of Dr. Rotten Apple became obvious to our medical community, especially those who practice spine surgery.  Many, including myself, complained through the established channels of hospital committees and medical societies and boards.  The result: highly paid attorneys attacking those practitioners who were concerned enough to speak out.  When threatened with litigation myself, I consulted Mr. Neil Galatz, the same attorney whom you praised in your letter.  Mr. Galatz's advice to me was that unless I was willing to spend considerable time, effort and my personal money, with the risk of punitive damages, I should stop all efforts to spotlight Dr. Rotten Apple.

            For nearly six years Dr. Rotten Apple became one of the busiest spine surgeons in Southern Nevada.  If complications occurred, patients were just readmitted to a different hospital facility than that in which the original surgery took place.  The complexity of confidentiality legislation, and the threat of further litigation, prevented one hospital from accessing information from another.  Dr. Rotten Apple, despite being dropped from many insurance plans, negotiated with others to provide to him an exclusive or near exclusive source of patients.  This however pales, in respect, to the vast number of patients who were directed to his office by personal injury attorneys and other practitioners affiliated with them.  This practice continued up until the day Dr. Rotten Apple left town.

 

Care to help in the solution?

            You have suggested that physicians "ban together as a critical mass" to address the Malpractice Crisis.  Perhaps we could take the lead from the Nevada Trial Lawyers Association (NTLA).   Your organization seems to now have also banded together, to attempt to assure that along with a right to health care, patients also have the greatest latitude and of course the opportunity, to sue. 

            There is one thing I do not see happening however.  The NTLA is quick to point the finger at insurance companies, hospitals, physicians, and anyone but themselves.  The NTLA and its members must also accept some responsibility for Dr. Rotten Apple, as well as our current Malpractice mess.  You and your colleagues must offer to be part of the solution.  Without this, any attempt to mitigate the crisis, and prevent a recurrence, will fail.

            To compare the situation today with the "Malpractice Crisis" of the mid-1970s is ludicrous.  Even adjusted for inflation, malpractice rates then were a fraction of what is proposed now.  In the 1970s physicians, not managed care, directed and determined how patients would be treated.  Medicare and Medicaid had just begun, and were well financed by the government.

            Now compensation from these federally regulated programs has dropped to the point that many physicians will no longer accept new patients enrolled in either, or are of an age that they would be so insured within the near future.  This is not to mention the rising costs office staff (including those hired just to fill out the mountains of paperwork and forms generated by managed care and the Medicare/Medicaid programs), increased rent and other fixed expenses, and the many credentialing fees (some as high as $300 per physician annually for each separate insurance company) that we are forced to pay to just participate in an insurance plan, with no guarantee of any patients. All of these, along with the cost of malpractice insurance, are now mandatory to allow a doctor the opportunity work for less overall money each year.

            Now you propose we "form our own insurance company" as the solution to the problem.  I will admit that your suggestion has merit.  This however is a complicated and expensive undertaking.  The Governor has offered a temporary plan as a stopgap measure.  Other more permanent plans are on the drawing board, but they really do not substantially lower our annual premiums.  Few, if any, address the lump sum tail coverage (some well into six figures) each physician may need to pay to protect his or her personal assets, and retirement savings, from lawsuits yet to be filed in the interim.  Furthermore, there is talk of an additional assessment for "start-up fees" for such a company.  We as the insured physicians have been asked to cover this also.

            Retaining and recruiting competent and responsible physicians is paramount to the health care of Southern Nevada.  Perhaps you should take the lead along with the NTLA, to help us form this non-profit insurance company.  Who will step forward first to provide the legal work pro bono to organize this company?  Should the NTLA help with the initial funding and start-up costs?  I am sure the NTLA has funds available that would normally be used for political contributions, public relations work, and the like.  Could we propose a surcharge on all newspaper, radio, and television advertising, in which lawyers use testimonials, turn into legal tornados and repair damaged vehicles with the snap of a finger, or promise to "take the first step", to get the maximum reward for their clients (and not to mention themselves).

            Without question, this community has well intentioned, talented, and honest representation, on both the plaintiff and defense bars.  Mr. Myers, I would offer you or any of your colleagues, a seat at the table if you are willing to meaningfully contribute to a solution.  It is time for the best of the legal profession to step forward and work jointly with us, rather than against us, to facilitate an end to this crisis.  There is too much at stake here, for our families, our community and state, and for ourselves.  We cannot allow a rotten apple from any barrel to ruin the entire crop.

 

Dr Venger is a board certified Neurosurgeon whose family has resided in Las Vegas for 39 years.  His father is a retired physician, and his sister and brother-in-law practice ophthalmology and internal medicine in Southern Nevada respectively.

 

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2002 Election Results

 

President Elect – Edwin Kingsley, MD  Oncology

 

Secretary – Kevin Hyer, MD  Diagnostic Radiology

 

Delegate Chair – Cyriac Chemplavil, MD  Pulmonology

 

Trustees

Michael Colletti, MD  Rheumatology

Michael Gross, MD  Nephrology

Jerry Jones, MD  Ob-Gyn

Eugene Speck, MD  Infectious Disease

David Steinberg, MD  Radiology

Arnold Wax, MD  Oncology

 

Nominating Committee

Richard Diskin, DO  Dermatology

Raj Chanderraj, MD  Cardiology

Howard Hoffman, Jr., MD  Pathology

Raul Meoz, MD  Radiation Oncology

Marietta Nelson, MD  Ophthalmology

Frank Nemec, MD  Gastroenterology

Ronald Slaughter, MD  Pathology

 

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CME CALENDAR

Cardiovascular Consultants             691-9154

Clark County Medical Society         739-9989

Southwest Medical Associates        242-7347

Some courses also approved for nursing CEUs.

6/13 - “Geriatrics in Primary Care,” 7:30 a.m., 1 hour

6/19 - “Ethics of End of Life Care,” 6 p.m., 2 hours

7/11 - “The Gastroenterologist and Primary Care Partnership,” 7:30 a.m., 1 hour

Sunrise Hospital                                731-8210

UMC                                                   383-2604

Valley Hospital                                  388-4847

6/11 - “The Use of Intravenous PPI’s,” noon

6/25 - “Update on Asthma,” noon

7/9 - “Vaginal Births After Cesarean Sections(V-Bacs),” noon

7/23 - “Making the Valley Hospital Web site Work For You and Your Patients,” noon

*Special Note:  CCMS members can receive free CME courses on the internet with World Medical Leaders.

To have your CME courses listed on our calendar, please contact Deborah Barton at 739-9989 prior to the deadline of the 12th of each month.

 

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CLARK COUNTY HEALTH DISTRICT DISEASE STATISTICS APRIL 2002

DISEASE                             CASES REPORTED       YEAR TO DATE

                                                4/ 2001    4/2002     2001        2002

VACCINE PREVENTABLE DISEASES

DIPTHERIA                               0              0              0              0

HAEMOPHILUS INFLUENZA    0              0              1              3

          (invasive)                                     

HEPATITIS A                            1              0              29            9

HEPATITIS B                            2              5              11            12

INFLUENZA                             0              6              28            57

MEASLES                                0              0              0              0

MUMPS                                    1              1              1              1

PERTUSSIS                              0              0              1              0

POLIOMYELITIS                       0              0              0              0

RUBELLA                                0              0              0              0

TETANUS                                0              0              0              0

 

SEXUALLY TRANSMITTED DISEASES

AIDS                                       19            28            60            82

CHLAMYDIA                           311          436          1255        1546

GONORRHEA                         150          153          564          544

HIV                                         10            27            40            56

SYPHILIS                                 0              3              1              4

          (Primary & Secondary)

SYPHILIS (Early Latent)          2              0              5              3

 

ENTERICS

AMEBIASIS                              0              2              0              7

BOTULISM-INTESTINAL           0              0              0              0

CAMPYLOBACTERIOSIS         10            12            41            32

CHOLERA                                0              0              0              0

CRYPTOSPORIDIOSIS             1              0              1              2

E. COLI O157:H7                     0              3              0              4

GIARDIASIS                             11            3              36            26

ROTAVIRUS                            17            66            263          256

SALMONELLOSIS                   8              11            42            52

SHIGELLOSIS                          4              1              12            1

TYPHOID FEVER                     0              0              0              0

YERSINIOSIS                           0              0              0              0

 

ANTHRAX                               0              0              0              0

BOTULISM INTOXIFICATION    0              0              0              0

BRUCELLOSIS                         0              0              0              0

COCCIDIOIDOMYCOSIS           3              4              10            10

ENCEPHALITIS                         0              0              0              1

HANTAVIRUS                          0              0              0              0

HEMOLYTIC UREMIC

SYNDROME (HUS)                  0              0              0              0

HEPATITIS C                            0              1              0              1

HEPATITIS D                            0              0              0              1

LEGIONELLOSIS                      1              0              2              0

LEPROSY (HANSEN'S DISEASE)             0                      0                      0                      0

LEPTOSPIROSIS                      0              0              0              0

LISTERIOSIS                            2              0              3              0

LYME DISEASE                       0              0              0              0

MALARIA                                0              0              1              1

MENINGITIS,

ASEPTIC/VIRAL                       6              2              15            20

MENINGITIS, BACTERIAL         1              2              9              11

MENINGOCOCCAL DISEASE   1              2              4              10

PLAGUE                                  0              0              0              0

RABIES (HUMAN)                    0              0              0              0

RELAPSING FEVER 0              0              0              0

RSV (RESPIRATORY              103          140          1170        1593

          SYNCYTIAL VIRUS)     

ROCKY MOUNTAIN SPOTTED 0              1              0              1

          FEVER                          

TOXIC SHOCK SYNDROME     0              0              0              0

TUBERCULOSIS                      9              9              25            17

TULAREMIA                             0              0              0              0

     *Numbers include confirmed and probable cases

 

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Calendar of Events

June 1 – Clark County Medical Society Installation Dinner and Awards Program at the Las Vegas Country Club with registration and cocktails at 6, followed by dinner and program at 7. Call CCMS at 739-9989 for details.

June 2 – Sunrise Hospital Cancer Survivors Day Celebration from 1 to 4 p.m. at the Sunrise Hospital auditorium. RSVP at 731-8788.

June 8 – Down Syndrome Organization of Southern Nevada 6th Annual Golf Tournament at Rhodes Ranch Country Club. Call 648-1990 for details.

June 13 – Nevada Medical Group Management Association meeting at Sunrise Hospital auditorium at 8 a.m. Call Stuart at 648-5700.

June 24 – D.A.R.E. Charity Golf Tournament at the Las Vegas National Golf Club. Call Eric at 390-DARE (3273).

 

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Classifieds

  • SPACE AVAILABLE FOR PRIVATE PRACTICE New building has space available in medical office for physician looking for freedom and independence. Fully staffed, centrally located in Reno, NV in high volume area. Share space, fees negotiable. Available September 2002. Call for further information at 775-826-5575 or e-mail HCRENO@aol.com. Ask for Dr. Shauna Olsen.
  • X-RAY EQUIPMENT. LIKE NEW! 500 MA Continental 125 KV with high frequency generator. Wall Bucky stand. Four-way float table. Floor rail mounted tube stand. Konica table model automatic processor. Cassettes - other accessories. New $20,000.00. Yours for only $9,800.00. Please call Family Medical Group, Evelyn (702) 459-5500.
  • MEDICAL SUITES FOR LEASE: Two medical suites, 2,507 and 2,602 sq. ft. available in Northwest for long term leases. New/upgraded building near Mt. View Hospital. Ambulatory/Surgery Center on site. Triple net leases. Will pay for tenant improvements or free rent. Call 839-2855 for information.
  • OFFICE SPACE AVAILABLE. Desert Professional Plaza, 2225 E. Flamingo Rd., Ste. 103 (Across from Desert Springs Hospital). 1160 sq. ft., 3 exam rooms w/sinks, phones stay, computer wired, furniture and some medical equipment stays if desired. Reasonable rent, utilities included. Full/PT rental considered. Call 734-2292, Dr. John Pinto/Deena.
  • FOR LEASE, MEDICAL OFFICE:  Del Webb Medical Plaza in Green Valley, approx. 2335 sq. ft., turn key with four exam rooms, one procedure room and nice decor. Call Connie at 702-951-0770.
  • PHYSICIAN WANTED. Immediate opening for established wellness center in Las Vegas, part-time 8-12 hours per week. For information call the office at 733-9797 Mon.-Thurs., 8:30-6:00 and Friday 8:30-2:00, after hours cell 880-9616.
  • CLASSIFIED ADS ARE FREE (up to 40 words) for CCMS Members. An $85 value! For information on classified or display advertising, call Deborah at CCMS, 739-9989.

 

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