Letters to the Editors

Career Guide: Kudos and knocks

Congratulations to Deborah Grandinetti and the entire Medical Economics staff for Your Career Guide [Jan. 8]. In addition to having all our consultants read this outstanding issue, we are recommending it to the physicians who use our recruitment services.

Joseph Hawkins
Chief Executive Officer
The MHA Group
Irving, TX

I am disturbed by some of the nontraditional revenue enhancers discussed in your Career Guide article, "Make your practice more profitable."

In the section "Boom times in the nip-and-tuck business," your writer states that cosmetic procedures "have come to be viewed as perfectly compatible" with the practices of dermatologists, GPs, and gynecologists. I can understand dermatologists doing dermabrasions and hair transplants, since most of them have been trained to do so. But gynecologists performing breast augmentations, abdominoplasties, and suction lipectomy?!

Plastic surgery residents spend up to three years learning when and how to do these procedures, and—more important—when not to do them.

Lawyers are having a field day filing malpractice suits against physicians who performed procedures in which they weren't properly trained. How can we possibly defend a gynecologist in a breast augmentation case?

Saul Hoffman,
MD Professor of Surgery
The Mount Sinai School of Medicine
New York, NY

Doctors who follow their conscience should be lauded

The Practice Beat item, "Court: A doctor can't be fired for wanting the best for his patient" [Jan. 22], indicates that a California appellate court has reinstated anesthesiologist Nosrat Khajavi's wrongful-termination suit against his employer. Khajavi had been fired after refusing to anesthetize a cataract patient who was in atrial fibrillation.

I am disgusted that there are physicians who would turn their backs on primum non nocere for the sake of profits! The medical group's shareholders can say whatever they want about why Khajavi was fired. If anything, they should feel blessed to have had a conscientious physician like Khajavi.

I wonder if the firing was racially motivated?

Jeffrey Basa, MD
jbasamd@excite.com

Professional courtesy: A nonphysician's opinion

Please excuse this lay expert for commenting on the Dec. 18 letter regarding professional courtesy to other doctors. It has been illegal for some 30 years. I am not an attorney, but you would do well to seek one's advice. What is the saying about a physician who treats himself?

Peter Vercilla
Pittsburgh, PAvercillapm@msx.upmc.edu

It's not worth the hassle to hustle patients

Before physicians sign on to programs to sell nutritional supplements to their patients, like the one advertised in the Dec. 4 issue, they should carefully check whether such an arrangement will run afoul of the disciplinary rules in their state.

Selling products to patients poses a conflict of interest and opportunity for undue influence. New York, for example, defines professional misconduct by a physician as "exercising undue influence on the patient, including the promotion of the sale of services, goods, appliances, or drugs in such manner as to exploit the patient for the financial gain of the licensee."

René H. Reixach, JD
Woods Oviatt Gilman LLP
Rochester, NYrhr@woodsoviatt.com

Edited by Gail Weiss,
Senior Editor

Address correspondence to Letters Editor, Medical Economics magazine, 5 Paragon Drive, Montvale, NJ 07645-1742. Or e-mail your comments to meletters@medec.com, or fax them to 201-722-2688. Include your address and daytime phone number. Letters may be edited for length and style. Unless you specify otherwise, we'll assume your letter is for publication. Also, let us know if you don't want your e-mail address printed with your letter.

Gail Weiss. Letters to the Editors.

Medical Economics

2001;5:11.