Election-Year Politics Push Medical Liability Skirmishes to Trenches

Election-year politics have sidelined several legislative attempts to cap noneconomic damages in medical liability suits, but that has not prevented individual physicians, states, and professional organizations from taking action.

The American College of Radiology (ACR) recently expelled a member for wrongful lawsuit testimony. A story that appeared on the web site Aunt Minnie , accessed July 12, 2004) stated that the ACR Committee on Ethics determined that E. James Tourje, MD, an attending staff radiologist and neuroradiology specialist with Cedars-Sinai Health System in Los Angeles, provided biased and clinically inaccurate testimony in two different lawsuits. This is the first time that ACR expelled a member for wrongful testimony while serving as an expert witness in malpractice lawsuits.

The ACR began collecting complaints about expert-witness testimony in July 2002, and has since received nine complaints about eight members; five of these cases have been resolved. The ACR’s crackdown on members who wrongfully testify results in the member not being able to serve as an expert witness, lowering the chances of unnecessary malpractice payments, which eventually raises physicians’ premiums.

The increase in medical malpractice costs is affecting physicians on an individual level by forcing some physicians to leave their practices and move to states where the malpractice premiums are more affordable. A recent story in Modern Physician, accessed on July 13, 2004) highlighted the odyssey of Theo Mellion, MD, an established neurosurgeon in downstate Illinois, who left his practice when he faced malpractice insurance premiums of $200,000 to $300,000 a year, leaving the community of Carbondale without a neurosurgeon. Mellion’s partner Sumeer Lal, MD, left earlier this year.

Fearing that other physicians would follow suit, the City Council of Carbondale passed an ordinance capping noneconomic damages in medical malpractice cases that involve events that take place in the city. Mellion and Lal were the only two neurosurgeons in their part of Illinois, and, according to the story, they performed 600 to 700 surgeries a year.

Some states, such as California, have taken action to cap malpractice premiums to keep costs affordable for physicians. The California medical malpractice law (created in 1975) enforces a payment cap of $250,000 on the amount of payout for patients’ noneconomic charges, such as pain and suffering; there are no caps on economic charges, such as lost wages or medical expenses, however.

Abolish Con?

If state and federal lawmakers heed the recommendations in a new 361-page report entitled “Improving Health Care: A Dose of Competition,” just released after 2 years of hearings into health care competition by the Federal Trade Commission and the US Justice Department’s antitrust division, there will be more, not less, competition in the coming years, not just from other specialties but from within radiology as well. The report ( www.ftc.gov ) recommends that states with certificate-of-need laws consider repealing them, and suggests that competition is a key to increasing quality and lowering health care costs.

Top MRI Procedures in 2003

Brain/brain stem procedures were the most performed MRI studies in 2003, claiming 31% of the market share, according to a report published by AMR Inc, Malvern, Pa. MR angiography and MRI procedures on the spinal canal and contents, and lower and upper extremities, joint, were also among the top procedures in 2003. Overall 2003 growth rate for the modality was 8.1%, with the strongest growth in volume seen in lower extremity, nonjoint MRI studies.

Other segments that showed significant growth in 2003 included MRI of the (complete) abdomen (22.3%) and angiography (19.5%)


Michael S. Steinberg, MD

Michael S. Steinberg, MD, a board member of the American Society for Therapeutic Radiology and Oncology, has been appointed to serve a 2-year term as a voting member on the Centers for Medicare and Medicaid Services Medicare Coverage Advisory Committee…Milton Silva-Craig has been promoted to the added role of president, in addition to serving as COO, of Emageon, Birmingham, Ala, a provider of intelligent visual medical systems. Additional promotions within Emageon include: Scott McFarland, who was appointed to senior vice president of service; Tod Hanson, now the vice president of project operations; and Donna Kralowetz, the new vice president of finance and controller…The Society of Nuclear Medicine (SNM) named the following people to leadership positions during its 51st Annual Meeting in Philadelphia, which was held on June 19-23, 2004: Mathew Thakur, PhD, was appointed president of SNM through June 2005. Thakur is currently a professor of radiology and radiation oncology, and director of radiopharmaceutical research and nuclear medicine research, at Thomas Jefferson University Medical College, Philadelphia; Martin P. Sandler, MD, was named vice president-elect of SNM through June 2005, and will serve as president-elect through June 2006, and then as president through June 2007; and Valerie Cronin has been chosen as president-elect of the Society of Nuclear Medicine Technologist Section (SNMTS) through June 2005, after which she will serve as president to June 2006…The following honors were received at SNM’s 51st Annual Meeting: Michael J. Welch, PhD, was presented with the 2004 Benedict Cassen Award, a biennial honor given to a living scientist or physician-scientist whose work has led to a major advance in basic or clinical nuclear medicine science; Abass Alavi, MD, received the 2004 Hevesy Award, which recognizes individuals for outstanding contributions to the field of nuclear medicine; Michael D. Devous, Sr, PhD, received the 2004 Kuhl-Lassen Award, which credits scientists who have made significant contributions in the field of functional brain imaging using SPECT or PET; and Hank F. Kung, PhD, was given the 2004 Aebersold Award for outstanding achievement in basic science applied to nuclear medicine. Kung’s work focuses on the development of radiopharmaceuticals and drugs used in the diagnosis of degenerative neurological diseases…Jim Champagne and Paul Dandrow have been promoted to president, and executive vice president and COO, respectively, of InSite One, Wallingford, Conn…Lynn A. McVey, administrative directorradiology at St. Joseph’s University Medical Center in Paterson, NJ, has been named the 2004-2005 president-elect and 2005-2006 president of the American Healthcare Radiology Administrators…Jim Beutel has joined Evolved, Nashville, Tenn, a provider of integrated image and information management solutions, as vice president of sales and marketing.

Industry News

InSight Health Services Holdings Corp, Lake Forest, Calif, has filed for the initial public offering of income deposit securities (IDSs), which represent shares of InSight’s Class A common stock and senior subordinated notes, as well as separate senior subordinated notes of the same series as the ones represented by the IDSs. Additionally, InSight’s subsidiary, InSight Health Services Corp, will begin a tender offer and consent solicitation for all of its outstanding $250 million aggregate principal amount of 9.88% senior subordinated notes due 2011…Siemens Medical Solutions, Malvern, Pa, acquired CADVision Medical Technologies, Jerusalem, strengthening its position in the area of computer-aided detection and diagnosis, and enhancing its oncology solutions product portfolio… AMICAS Inc , Ridgefield, Conn, a web-based PACS company, and a wholly owned subsidiary of VitalWorks Inc, Ridgefield, Conn, has received the top rating for PACS in the KLAS Top 20: 2004 Mid-Year Report Card, based on a detailed KLAS customer survey of health care information technology performance data contributed by thousands of health care executives and professionals…GE Healthcare, Waukesha, Wis, and Confirma, Kirkland, Wash, have signed a strategic alliance under which GE will distribute Confirma’s CADstream™ software to its magnetic resonance customers worldwide…Eastman Kodak Company’s Health Imaging Group, Rochester, NY, will spotlight women’s health by featuring two pink ribbons framing the slogan of “Kodak Mammography Film” on the No. 77 Kodak Racing Dodge, which will make its debut at the Watkins Glen International NASCAR race on August 15, 2004, in Watkins Glen, NY. The car will be driven by Brendan Gaughan…United Marketing Group, Harrison, NY, has signed a national distribution agreement with FUJIFILM Medical Systems USA, Stamford, Conn, to distribute Fuji’s medical films to all nonhospital clinical markets, such as freestanding offices, clinics, and imaging centers, as well as to veterinary and dental markets…Agfa, Ridgefield Park, NY, has signed a multi-year reseller agreement with Initiate Systems Inc, Chicago, under which Agfa will offer Initiate’s Enterprise Master Person Index software for patient and provider data management as an integrated component of Agfa’s IMPAX enterprise image management solution. Agfa’s IMPAX recently received the Approval to Operate and a Certificate of Networthiness by the US Air Force Surgeon General’s office and the Air Force Communications Agency. IMPAX is the first PACS solution to receive the accolades, which are based on rigorous guidelines defined by the Defense Information Systems Agency, in accordance with the Department of Defense regulations for IT security…RamSoft Inc, Toronto, a developer of PACS and teleradiology software solutions, has selected Cogent Medical Systems Inc, Mount Laurel, NJ, to be the national sales agent for RamSoft in the United States, effective July 1, 2004…TeraRecon Inc, San Mateo, Calif, announced that PENTAX Corp, Tokyo, has made a capital investment in TeraRecon, acquiring 341,000 shares of newly issued series G preferred stock, which represents 2.18% of issued equity. The companies have also entered into a strategic alliance agreement, in which TeraRecon has awarded PENTAX the right to include TeraRecon’s signal and image processing processor and software technologies in products targeted for specific markets. TeraRecon has also entered into a nonexclusive product licensing and distribution agreement with iCAD Inc, Nashua, NH, under which TeraRecon will develop a new server-based product offering that includes iCAD’s lung cancer detection, analysis, and tracking software in various configurations…The Society for Computer Applications in Radiology is offering two $40,000 research grants in 2005. Eligible research topics include basic and clinical research involving computer applications in radiology, as well as the development of hardware, software, or innovative processes to support radiology practice, education, or research. The deadline for the 2005 grants is September 7, 2004.