UPDATE

Focus on Practice

By Joan R. Rose

Prescription drug prices could trigger a new revolution

Earlier this year, Springfield, MA, unveiled a voluntary program to allow current and retired city workers to purchase prescription drugs from a Canadian outlet. This program could save the city $9 million a year. Now at least three states, Illinois, Iowa, and Minnesota, are considering similar plans for state employees, despite the FDA's policy prohibiting state and local governments from importing drugs from Canada.

The FDA is unbending in its conviction that reimported drugs could be unsafe. And while the agency hasn't moved against Springfield, it has warned CanaRx Services, the Detroit-based company through which Springfield buys its drugs, that the FDA would seek to shut it down or take other legal action if the company continues to violate the federal Food, Drug and Cosmetic Act.

Even on the runway, doctors have a tough time besting lawyers

Last May, 22-year-old Tina Sauerhammer became the youngest graduate of the University of Wisconsin Medical School. In September, she vied for the Miss America crown only to finish second runner-up to a lawyer wannabe, Miss Florida Ericka Dunlap. Sauerhammer aspires to be a pediatric surgeon and expects to begin her surgical residency in Fall 2004.

CMS eases the EMTALA burden

The Bush administration has published a rule reducing the compliance burden for hospitals and physicians under the Emergency Medical Treatment and Labor Act. For instance, hospitals will have greater discretion in arranging physician coverage to treat emergency department patients. Physicians may have "on call" duty now at more than one hospital simultaneously and may even schedule elective surgical or other procedures during that time. In addition, physicians' offices and other nonhospital facilities are exempt from compliance under the law—even if owned by a hospital.

Ob/gyns are unhappier than primary care physicians

The majority of obstetricians and gynecologists are satisfied with their careers and believe that they can deliver high-quality care to all of their patients, according to a recent study. Yet these doctors are significantly less satisfied with medicine than their primary care counterparts and less likely than primary care physicians and general surgeons to believe in their ability to deliver high-quality care, or to obtain needed services.

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Joan Rose. UPDATE: Focus on practice. Medical Economics Nov. 7, 2003;80:12.