The American Medical Association bowed out of its embarrassing endorsement deal with Sunbeam Corp. last month, but another group of physicians is proceeding with plans to cash in on consumers.
As of last week, 64 physicians had joined the newly formed Association of Professional Team Physicians, whose members treat players in Major League Baseball, the National Basketball Association, the Women's NBA and the National Hockey League.
The association, which is actually a limited liability company, was conceived by Norman Scott, M.D., chairman of orthopedic surgery at Beth Israel Medical Center in New York and team physician for the New York Knicks, and David Checketts, president and chief executive of New York's Madison Square Garden.
Plans include issuing a seal of approval for sports products, accrediting sports clinics and marketing a line of orthopedic supports under the brand name Stardox. Members pay no dues but are promised a 5% cut of the profits.
The association's vice president, Marc Allen, termed these activities "consumer education."
Tenet's thorn.It appears it's Tenet Healthcare Corp.'s turn to be under pressure from a local community group.
The West County Coalition to Save Health Care, a citizens group worried about what it sees happening in Contra Costa County, east of San Francisco Bay, is trying to hold all out-of-town owners of local hospitals accountable for what it believes to be declines in service. It's motto: "Stick Corporate Medicine Where It Hurts."
"We've set up a Tenet Tip Line for folks to report long lines, poor treatment, minimal staffing, etc.," reports self-described social terrorist Susan Prather. She has been on Tenet's case since the company announced plans to reduce acute-care services at Doctors Hospital of Pinole (Calif.) and transfer services to nearby Brookside Hospital in San Pablo.
Now, armed to fight managed care and other for-profit "corporate medicine," Prather is soliciting examples of poor care from the public and medical professionals and forwarding them to HCFA, the California Department of Health Services or the state Legislature. "So far the stories have been pretty bad and horrifying to say the least," Prather says.
Tenet spokesman Lance Ignon, noting that the company has added nursing staff and invested $3 million in Brookside, finds it "curious" that Prather is trying to "undercut our efforts." Tenet intends to stick around in Contra Costa for the long haul, he says.
Suited.Jonathan Lord, M.D., the head of the American Hospital Association's corporate headquarters office in Chicago, has decided to buck a major social trend by ordering his remaining troops back to formal business attire from office casual.
While even IBM Corp., once a bastion of white shirts and dark suits, has gone full casual, Lord sees the need to button down at the AHA.
The AHA Chicago office went casual when staffers were moving three years ago to the association's new leased space in the city's Loop from its old office headquarters. The AHA's Washington office always has required business attire.
"It'll be slacks and ties for the men," says Richard Wade, senior vice president for communications. Jackets also are required, but AHA executives say most people get to work and put their jackets on their chairs.
The AHA has slashed its total payroll by more than half in the past five years, most of the cuts coming in the Chicago office. The latest move angered a number of staffers, one of whom says, "I got rid of a couple of my older suits a while back. Now I have to buy a bunch of new suits and ties. Who ever heard of going back to suits from office casual?"
Urban agenda.HMOs apparently have skipped over smaller markets in their grab for market share.
According to a report by InterStudy, a Minneapolis-based managed-care research firm, three-quarters of HMO growth in the past three years-about 12 million enrollees-occurred in metropolitan markets with more than 1 million people.
Markets with between 250,000 and 1 million people saw average HMO penetration creep from 18.3% to 20.8% since 1994. In markets with less than 250,000 population, managed care is idling. Those figures compare with a jump from 23.3% to 31.2% in big cities.
Still, HMOs face a major hurdle in big markets. A large supply of providers, particularly specialists, spurs high utilization that can't always be offset by a competitive HMO market, InterStudy says, citing New York City as an example.
Author, contributor.When a number of researchers at multiple institutions write a scientific article, how are peers to sort out who's responsible for what in the published paper?
That was the theme of a lengthy piece (by multiple writers) in the Aug. 20 edition of the Journal of the American Medical Association. The authors, Drummond Rennie, M.D., JAMA's deputy editor; Veronica Yank at the Institute for Health Policy Studies at the University of California at San Francisco; and Linda Emanuel, M.D., the AMA's ethics conscience, wrote that scientific authorship has become such an amorphous and treacherous term it should be dropped. Too many conflicts arise among putative authors involved in multicenter medical trials, so they suggested replacing "author" with "contributor" and describing specifically what every contributor has brought to the finished product.
Given the article's high pedigree, does that mean these changes will be instituted at JAMA?
"The journal," answers editor George D. Lundberg, M.D., "is happy to allow authors such as Dr. Rennie to provide articles for publication after proper peer review, so the world can see the ideas and respond to them. We're happy to be a forum for such intellectual exchanges."
As for the article, Lundberg says, "My personal opinion is that the academic community will ignore it completely."