A book to help self-destructive patients; When generalists perform stress test; A group's liability when a member is sued; There's no business like show business; Wearing many hats--and nametags
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FP Kerri Peterson's story of how she saved the life of a neighbor who had tried to kill herself ["My Wednesday Off," May 23] did not address how a physician could help someone who may be suicidal. Let me suggest a book, How I stayed alive when my brain was trying to kill me: One person's guide to suicide prevention, by Susan Rose Blauner (William Morrow, 2002). Written by a young woman after years of suicide gestures and serious attempts, it is a worthwhile addition to the sparse armamentarium of suicide-prevention tools we physicians can draw on.
David L. Arkin, MD
Glen Allen, VA
Your Malpractice Consult about the liability issues that arise when primary care doctors perform cardiac stress tests seemed to suggest that we generalists are not qualified to do the job ["Stress test responsibilities," May 23]. This was a disservice to your readers.
We primary care physicians are well aware that we're held to the same standard of care as specialists when we perform procedures such as cardiac stress tests and endoscopies, or when we offer dermatologic or obstetric services. But this does not preclude us from providing such care; it just requires that we receive proper training.
It is my responsibility as a physician to maintain my skills and practice within the scope of my expertise, whatever procedures I choose to perform. The important thing is knowing one's limitationsnot having others impose limitations needlessly.
Kristin K. Elliott, MD
I really enjoyed Berkeley Rice's article, "Could a malpractice mega-verdict wipe you out?" [May 23]. One point that he did not mention, though, is that plaintiffs' attorneys can go after a medical group's accounts receivable if the corporation is sued along with an individual doctor. Even if they were not personally named in the suit, all the shareholders' A/R can be taken.
Anesthesia Associates of Louisville
I really appreciated "Do you care too much?" [May 23]. Well written! Well said! I know. I've been there. Seventeen years ago, I was "doing it all"coming in early, staying late, attending every meeting, responding immediately to every request, justifying every recommendation.
Then I had major cancer surgery. Things changed. I did less and appreciated things moreand my patients seemed to appreciate me more. Three months after my second cancer operation I was playing Chief Sitting Bull in a community theater production of Annie Get Your Gun. Now at the age of 62, I'm cancer free, still workingand still delighting my patients and colleagues on stage at our local community theater.
Joshua B. Grossman
Johnson City, TN
When I graduated from medical school, I became a "Medical Doctor." Then I started my internship as a "House Officer." After three years of residency, I became a "Fellow," and, finally, a licensed "Physician." Then came managed care, and nowlumped in with therapists and naturopathsI'm a "Provider." To my liability carrier, I'm an "Insured Member." On the EOBs of some health plans I appear as a "Vendor." And now, under HIPAA, I have become a "Covered Entity" and have assumed the role of "Privacy Officer."
What's next? It's so nice when my patients still greet me with "How are you, Doc?"
Roswitha Moehring, MD
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Letters to the Editors. Medical Economics Sep. 5, 2003;80:10.