Medical Turf Battles

May 12, 1992

Gov. William Donald Schaefer has some tough decisions to make in the next few weeks as he mulls over the list of General Assembly bills to be signed or vetoed. The thorniest ones deal with intense turf battles among medical practitioners.

There are two bills on the governor's list that we feel deserve a veto, and two others that he ought to sign into law. All of them relate to the level of medical training and supervision of practitioners.

One measure that he should reject would permit minimally trained office personnel to give X-ray tests in doctor's offices. JTC This is a dangerous step that could create health hazards in some doctors' offices and lead to over-radiation of patients and additional patient X-ray costs. Studies indicate that self-referring physicians charge four to seven times more for X-rays and subject patients to four times more X-ray exams than when the doctor sends the patient to a radiologist.

The bill would let anyone with just 30 hours of training administer certain X-rays, with no peer review, no regulatory oversight and no mandated continuing education. It is a measure that will financially benefit private physicians to the detriment of the public.

A second veto is warranted for a special-interest bill from Sen. Frederick Malkus of Dorchester County. It would permit a small number of individuals who don't meet the academic criteria for the psychologist's licensing examination to take the test anyway. National, state and academic medical groups oppose this exception, and we agree.

Two other measures that have stirred medical controversy also are on the governor's desk. One would create a new certification for social workers who do clinical therapy. It is a sensible approach to enhance the medical testing by the state for these health practitioners. The second measure would let some podiatrists treat ankle as well as foot problems. This bill was vetoed last year but has since been improved with safeguards that give hospitals much-needed control over podiatrists permitted to do ankle surgery. Both measures should be signed by the governor. They tighten certification requirements or oversight of medical activities.

Clashes among medical specialists are always among the more bitter and intense in the State House. Mr. Schaefer would be wise to ignore the heavy lobbying taking place to influence his decision on these four measures and to make up his mind on the basis of what is best for the citizens of Maryland, not the vested interests.

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