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Your article "Malpractice: Why you may be forced to settle" [Feb. 22] did not resonate well with me. You failed to point out the alternative to the large, commercial insurance carriers whose cost cutting consigns doctors to a second-rate defense: physician-owned and operated malpractice insurance companies.
Their strengths are exactly what your article advised us to look for when buying malpractice coverage: they spare no expense to defend doctorsespecially in obtaining topnotch medical experts; they will not settle without your consent; and they offer the best attorney panel available and a local, knowledgeable claims staff for prompt answers to your questions.
Money spent for premiums becomes insignificant when you have such a partner on your side at times of crisis.
R.W. Keller, MDAnchorage, AK
In describing how malpractice carriers pressure defense lawyers to keep expenses down, attorney Rick Evans says: "When you're being nickel-and-dimed by some number cruncher at the insurance company, it prevents you from giving your client your best representation." Read that sentence again, but this time use "patient" instead of "client," and "care" in place of "representation." Sound familiar? It's the most serious problem facing physicians today: managed care.
We can learn a lot from lawyers' proactive response to their problem of "managed law." They are successfully taking insurance companies to court. It's time for us to act as well!
Rodolfo Martinez-Ferrate, MDGallup, NM
It was inappropriate to publish a letter from Sen. Arlen Specter campaigning for therapeutic cloning ["Letters to the Editors," April 12]. Where's the letter from a senator presenting the other side of the issue?
John M. Lawlis, MD Indianapolis
Editor's Note: Although we haven't received a letter from a senator speaking out against therapeutic cloning, we understand the desire to hear the other side. Sen. Bill Frist (R-TN), a physician, opposes all forms of human embryo cloning. So here are excerpts from his April 9 remarks in the Senate (full text available atwww.aau.edu/research/frist4.9.02.html):
Can one truly be an advocate for stem cell research and, at the same time, oppose human cloning experimentation? The answer is Yes.
I am a strong supporter of stem cell research. Cloning of DNA and any cells that are not or will not become an embryo will continue. The promise of stem cell researchfor Parkinson's disease, autoimmune disorders, cardiovascular diseasewill progress with a ban on human cloning research in place.
But if one supports therapeutic cloninggiven our understanding of science todayyou are in support of purposefully creating an embryo, of removing the cells, and thereby destroying that embryo. Regardless of our religious background, most of us are extremely uncomfortable with this idea.
At this point in the evolution of this new science, I believe there is no justification for the purposeful creation and destruction of human embryos in order to experiment with them, especially when the promise and success of stem cell research does notdoes notdepend on the experimental research cloning technique.
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Liz O'Brien. Letters to the Editors. Medical Economics 2002;9:8.