Saturday Mailbox


December 24, 2005

Improving oversight of juvenile justice

Gov. Robert L. Ehrlich Jr. has been unwavering in his commitment to the Office of the Independent Juvenile Justice Monitor (OIJJM) and its team of monitors, who work hard every day to ensure that youths in the Department of Juvenile Services (DJS) facilities are safe, secure and receiving appropriate services.

He demonstrated this commitment when he signed the executive order that re-established the OIJJM and mandated its continued authority, exactly as it had existed previously in law.


Students uphold spirit of altruism

A key point that has been neglected in the debate over Loyola College's Care-a-Van program is that Loyola students don't want to have to serve these sandwiches ("Accord reached on feeding homeless," Dec. 17).

As a student who has been involved in the program myself, I wish I could devote my time to other activities besides helping people who are homeless, because I find it ludicrous that the problem exists in the first place.

Unfortunately, people are suffering unnecessarily, and as a result, students will continue the charitable work we have done for decades, despite all opposition.

Loyola students acknowledge that people experiencing homelessness deserve better than a sandwich on the street or even a meal at a meal program.

However, such handouts will remain necessary until city officials make a commitment to pursuing systemic change to end poverty.

The writer of the letter "The homeless need more than just food" (Dec. 16) suggests that the key factors in ending homelessness in Baltimore will be affordable housing, a living wage and universal health care.

While I agree with this evaluation, I would also suggest that a spirit of altruism is equally important

The Care-a-Van volunteers should not have been prevented from doing their work. Rather, they should be held up as a model for us all.

The city's new health commissioner has taken an important step in conveying this message by allowing the students to continue serving food. I can only hope that this is a sign of his commitment to the materially poor.

If that's the case, I can promise him that Loyola students - sandwiches and all - will be here to help.

Gregory Sileo


The writer is a senior at Loyola College.

Taking the mask off malpractice?

The Sun's series on the availability of physician malpractice histories shed more heat than light on the subject ("Masking Malpractice Cases," Dec. 18-20).

And a close examination of the articles reveals some interesting facts, and important omissions.

First, of the 17,000 physicians the series says are practicing in Maryland (and I think the actual number is more like 12,000), just 120 (or 0.7 percent) have been the subject of five or more claims over a decade.

That's claims, not judgments or settlements or determinations of fault.

And 10 years is a very long time, far longer than the period most malpractice insurers use to decide whether to insure a doctor.

Second, physicians recognize that a potential pattern of behavior may be suggested by a series of multiple awards against a physician, but not by multiple allegations alone and not over an unreasonably long period of time.

The current law recognizes this by requiring the Board of Physicians to post on its online physician profiles the identity of physicians against whom there have been three or more arbitration award or judgments of at least $150,000 over five years.

But since very few such doctors appear on its Web site, the series suggests that out of the tiny number of doctors who have been sued five or more times over the past 10 years, virtually none has occasioned three or more awards or judgments of at least $150,000 in the past five years.

And the series' underlying premise - that malpractice claims histories are an important tool for evaluating physicians - is faulty.

Malpractice data are proved to be unreliable and misleading indicators of physician quality.

Scientific literature shows that lawsuits against physicians, including cases in which awards or settlements result in payment, rarely are found to involve deficient care, as judged by independent peer review of the facts.

Conversely, most patient injuries judged by independent peer review to be the result of deficient care do not result in lawsuits.

The series also fails to make clear the correlation between multiple claims against certain physicians and their work in high-risk specialties or in high-risk environments such as emergency departments in certain jurisdictions or in academic centers that treat the toughest-of-the-tough cases.

These physicians know that when they take care of patients in these circumstances, they are putting themselves in harm's way - too often for no payment or other benefit to themselves, except the knowledge that they are serving their community.

They know that they can avoid that risk simply by doing some other work. Unfortunately, that is exactly what is happening in Maryland's high-risk, high-cost, low-payment environment.

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