When several hundred doctors across south Texas shuttered their offices April 8, walking off the job in a peaceful demonstration against soaring medical malpractice coverage costs, they may have set a precedent for protest in other states that have been rocked by the insurance crisis.
Call it civil disobedience for the white-collar crowd.
"Given the sense of helplessness and futility they've been feeling, standing together was invigorating," says Kim Ross, vice president of public policy at the 37,000-member Texas Medical Society. "Some who called were almost teary-eyed, saying they've never seen so many doctors together, galvanized by one issue."
The issue, of course, involves malpractice rates that the medical society estimates have skyrocketed from 100% to as much as 300% for some specialties in especially hard-hit counties in the southern section of the state, where the "day of awareness protest" was centered.
Asked about future protests on a national level, Ross says it's highly unlikely that doctors will ever mount anything as drastic and dramatic as, say, a march on Washington. For one thing, he says, the biggest and most impressive protest in history won't change the fact that there are not enough votes for meaningful tort reform in the Senate.
Still, similar protests among doctors in other parts of the nation are a strong possibility, Ross says.
"This is most immediately and of necessity a state legislation, and a state regulatory issue," he says. "I was in Washington recently and there was a lot of interest among my counterparts (in the one-day protest). Quite a number of my colleagues expressed interest, and their own physicians expressed interest."
Fish on Prozac?
Researchers are investigating whether the millions of doses of prescription drugs swallowed by Americans to cure such ills as cancer, heartburn, depression and impotence may be harmful to aquatic life.
Scientists have already determined that the drugs people swallow don't just disappear into their digestive systems but make their way back into the environment via the waste stream. As a result, environmental engineers at Johns Hopkins University in Baltimore have launched a research program to identify the scope of the nation's prescription drug pollution problem. The study will be fueled by a three-year, $525,000 U.S. Environmental Protection Agency grant to study pharmaceuticals and antiseptics in drinking water, sewage-treatment plants and coastal waters.
Last week, members of the Johns Hopkins team unveiled two new scientific tools to aid in the investigation: a survey of the estimated environmental concentration of the 200 most widely used drugs and a lab test that can detect minute amounts of several prescription drugs in water samples. The researchers say it's important to track the drugs because many prescriptions are not rendered biologically harmless when they pass through the human body. In addition, conventional sewage-treatment systems may not be removing them and unused drugs may be flushed down toilets or thrown in the trash, ultimately landing in ground or surface water.
The research team pointed to ubiquitous antidepressants as an example of the problem. Many antidepressants work by altering levels of a neurotransmitter called serotonin, which also causes many aquatic creatures to spawn. Pharmaceuticals in the wild thus could upset breeding cycles. And we don't even want to think what small amounts of these drugs in drinking water could mean to pregnant women-but the researchers do.
As the project continues, the Johns Hopkins team plans to test water before and after it flows from drinking water-treatment plans to see how effectively pharmaceuticals are being removed. They will conduct similar tests at sewage-treatment plans in Massachusetts and Maryland. The Chesapeake Bay also will be sampled for the presence and concentration of drugs and antiseptics.
Dead to rights
Life is just a state of mind. Perhaps that's how Diane Nadolni sees it.
Late last month, Nadolni, 51, of Memphis, Tenn., admitted defrauding the government out of $5 million with a scheme to bill Medicare and Medicaid for clinical psychology services for 10 patients, at least some of whom were dead, according to the U.S. attorney's office in Memphis.
Prosecutors say Nadolni knew that those services were not provided or supervised by a clinical psychologist, as required by Medicare, or couldn't have been provided because the alleged patients were dead. Nadolni pleaded guilty to one count of healthcare fraud and one count of tax evasion, according to her plea agreement. In return, prosecutors dropped the other 51 counts with which Nadolni had been charged, many of which detailed the individual instances in which Nadolni fabricated bills for Medicare beneficiaries during 1997.
Prosecutors also agreed to put in a good word with the U.S. District judge in Memphis who is scheduled to sentence Nadolni on July 12. She could use the help. The healthcare fraud charge carries a maximum of 10 years in prison, while the tax charge could include up to five years in prison, prosecutors say. The judge may impose as much as a $250,000 fine for each charge.
A torch for Torricelli
Big hair and congested shopping malls aside, New Jersey does have something New York pines after: Democratic Sen. Robert Torricelli.
The Greater New York Hospital Association, which has been on a frantic search to find a champion of teaching hospitals to pick up where retired Sen. Patrick Moynihan left off, is taking him, thank you very much. Said the trade group's president, Kenneth Raske, at the association's annual meeting earlier this month: "There is no one who will ever replace our precious senator, but we believe Sen. Torricelli, who is on the Finance Committee, will be the next Pat Moynihan. Yes, we believe that."