Although the Senate has sent malpractice reform to the legislative intensive-care ward, a reform-advocacy coalition is holding itself together despite some major breaks in its ranks.
The chief dispute within the Health Care Liability Alliance is between the American Medical Association, which believes capping "pain and suffering" awards at $250,000 should be the coalition's main goal, and hospital and insurance groups that believe the top priority is limiting providers' liability for such awards to their proportion of the blame.
A four-hour meeting of the alliance last week unleashed a round of finger-pointing and, as one participant described, "bloodletting."
The AMA contended that the hospital and insurance groups were actively working against the cap on pain and suffering awards. The hospital groups said the cap was an unattainable goal-as proved later through its rejection by the Senate-and argued that the AMA's continued lobbying and advertisements in support of the cap endangered the whole malpractice reform package.
However, according to several coalition members, the blowing off of steam allowed them to forget the hard feelings. Now they say they have smoothed over what amounted to personal disagreements rather than substantive questions. They have vowed to put up a more united front the next time the issue reaches the Senate floor.
Doctor in the house?M.D., J.D., Ph.D., Ed.D.-will the real doctor please stand up? So asked Christopher Caldwell on a recent op-ed page of The Wall Street Journal.
Caldwell's essay blasts Americans' "doctor fetish"-the proliferation of meaningless doctoral degrees. What piques his irritation even more is that those who obtain the least worthwhile doctorates are the most insistent on being addressed as "doctor," especially those in education, the caring professions and government.
"You cannot become a real doctor in less than half-a-dozen years of medical school and without demonstrating a competence that will indemnify hospitals against a merciless malpractice climate," Caldwell ranted. The description of "doctor," he said, "is now, often as not, the last refuge of a mediocrity." By contrast, Ph.D.'s with real qualifications and achievements rarely care whether they're addressed that way.
Cut the pretentiousness, please, he advises. "Mister-or Ms.-will do just fine for anyone you wouldn't allow to stick a tongue depressor in your mouth."
Deals never die.Here's the rest of the story on how Columbia/HCA Healthcare Corp. signed its biggest not-for-profit acquisition yet, the nearly $400 million HealthOne deal in Denver.
About a year ago, HealthOne's chairman, Bob Alexander, approached Columbia's president and chief executive officer, Richard Scott, during a meeting at which Scott was speaking. Alexander told Scott he'd encountered Thomas Frist Jr. a decade earlier when Frist's Hospital Corporation of America tried to buy HealthOne.
Frist is now vice chairman of Columbia, but he's better known as the founder of HCA, which merged with Columbia last year.
In 1985, HealthOne, which was then a three-hospital system known as PSL Healthcare Corp., went on the selling block. HCA lost out to American Medical International, which offered $178 million.
At the time, Frist told Alexander that PSL's two main hospitals, Presbyterian Denver and St. Luke's, needed to be consolidated. PSL's board didn't want to do that, and AMI said it wouldn't; so AMI won the bid.
Ironically, AMI did consolidate the two hospitals. Alexander told Scott and Frist that he appreciated Frist's honesty back then.
During the past year, Frist has made numerous trips to Denver as chief negotiator in the HealthOne deal. Makes one wonder if 10 years from now Scott will be closing deals that got away from him in the early 1990s. Maybe Emory University in Atlanta?
Little pleasures.Encounters with the healthcare system may actually undermine patients' health, sapping them of their sense of control, confidence and optimism through prescriptions of restrictive, pleasure-denying health regimens, according to a new study.
The report, Healthy Pleasures: The Health Benefits of Sensuality, Optimism and Altruism, was presented by David Sobel, M.D., regional director of patient education and health promotion at Kaiser Permanente, at last month's Healthier Communities Summit in San Diego.
Sobel suggests that strict no-salt, no-fat diets; tedious exercise programs; avoidance of cholesterol; and other strict, pleasure-restricting health programs may not be the one true path to good-health nirvana.
Rather, the healthiest people seem to be the ones who allow themselves several small pleasures on a daily basis and cultivate an optimistic outlook on life. So playing with a pet, taking an afternoon nap, laughing, communing with nature, shopping, soaking in a hot tub, taking a vacation, pursuing a fulfilling hobby, sipping a glass of wine, savoring a bite of chocolate and helping others in need may all lead to considerable health improvement.
It's this lifestyle that results in reduced risks of heart attacks, cancer and increased immune function, Sobel said.