American Medical

Johns Hopkins University and University Physicians, the faculty practice plan at the University of Maryland, are among the parties to a lawsuit challenging federal audits of Medicare billing by teaching hospitals.The suit was filed Tuesday in federal court in California by the Association of American Medical Colleges, the American Medical Association and other professional associations, medical schools and teaching hospitals.The 2-year-old audit program is aimed at making sure faculty doctors in teaching hospitals bill only for work they do directly, not for work done by residents.

WASHINGTON -- The American Medical Association and representatives of the nation's medical schools said yesterday that the United States is training far too many doctors and that the number should be cut by at least 20 percent."

WASHINGTON -- Don't expect anything but a hemorrhage at the Treasury from that new program to counter the doctor surplus by paying hospitals to reduce the number of residency slots for the final phase of medical training.Reminiscent of the agricultural-support schemes that paid farmers for not growing crops, the medical plan was inspired by pTC an immutable law of American medical practice: More doctors mean more medical spending, despite the penny-pinching tactics of managed care. So, stop them before they can start hustling patients, the Washington strategists concluded.

IF JACK KERVORKIAN'S zealous crusade to help people die has now become a reason to legalize -- and thus regulate -- physician-assisted suicide, Dr. Timothy Quill is the perfect poster-doc for thoughtful advocates of the cause.Dr. Quill, a 47-year-old general practitioner in Rochester, New York, is everything you would want in a doctor. He treats a wide variety of complaints, often has several generations of the same family as patients and even makes house calls. He has impressive credentials, serving as associate director of medicine at Genesee Hospital and a professor of medicine and psychiatry at the University of Rochester.

Washington. -- Among the puzzlements of the moment is the record-breaking rush to get into medical school.With over 43,000 applications on file for admission next fall, the queue is up by 7 percent over last year's level, according to the official scorekeeper, the Association of American Medical Schools. As recently as 1989, fewer than 28,000 applied for admission.Since the number of medical schools in the United States has remained constant at 126 for many years, the competition for entry has heated up for the annual allotment of about 16,000 freshman slots.

NEW ORLEANS -- Top officials of the American Medical Association are appealing to doctors to show restraint in criticizing President Clinton's plan to overhaul the nation's health care system, even as members of the group vowed to seek major changes in the proposal.At a meeting yesterday that displayed the group's divisions over tactics and strategy in the coming battle over the nation's health care system, Dr. Joseph T. Painter, president of the association, said doctors should look for answers, not adversaries.

Washington. -- Like a feverish thermometer reading or a worrisome blood count, the alarming news from the world of medical practice is that times are good for the managers of medical practice.These are laymen -- not doctors -- who have mastered the mysteries of insurance forms, reimbursement regulations and the scheduling of patients to keep the doctors busy. The fact that the managers are doing well means that the administration of medical paperwork has ascended to a level of complexity that warrants a well-rewarded place on the payroll -- financed, of course, by patients.

Dr. H. Garland Chissell Jr. dies at 68Dr. H. Garland Chissell Jr., who practiced family medicine in West Baltimore for 40 years and helped direct the growth of Provident Hospital, died Monday at Johns Hopkins Hospital after suffering a heart attack. He was 68.A pioneer in the field of managed health care, Dr. Chissell also served as executive vice president and medical director of the defunct Monumental Health Plan, the first African-American health maintenance organization in Baltimore.The Petersburg, Va., native graduated in 1938 from Dunbar High School in Washington, D.C., and earned a bachelors degree in chemistry from Virginia State College in Petersburg in 1942.

As the population of the United States grows older and lives longer, the shortage of doctors trained to treat the problems of the elderly has become acute.Most doctors, even those who have a lot of elderly patients, have had little, if any, systematic training in geriatrics, and medical schools are only now introducing such training.According to Dr. Louis J. Kettel, a former medical school dean who is now a vice president at the Association of American Medical Colleges, doctors and medical educators nationwide are finding that their patient population has aged dramatically -- but that much basic knowledge about older patients is still lacking.

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Drug and medical device companies should be barred from offering free food, gifts, travel and ghostwriting services to doctors, staff members and students in all 129 of the nation's medical colleges, an influential college association has concluded. The proposed ban is the result of a two-year effort by the group, the Association of American Medical Colleges, to create a model policy governing interactions between the schools and industry. While schools can ignore the association's advice, most follow its recommendations.

BAGHDAD, Iraq-- --The young soldier would die, a fate ensured by the bullet that entered his right eye and shredded his brain. But unlike many other patients on the beds and gurneys of the U.S. Army's main combat hospital, this one would die quickly, without any heroic attempts to open his skull or take over his vital functions with machinery, without the chance to remain alive until his family or friends could gather. If the doctors thought he had a chance of survival, they might have treated him differently.

Through giveaways and sponsorships, the mamanufacturers of drugs and medical devices can distort the way doctors care for patients, a group of prominent physicians and scientists warns today in a call for reforms. The group recommends that academic medical centers ban some common practices, regulate others and make a concerted effort to disclose doctors' financial relationships with makers of drugs and devices. "Marketing and market values should not be allowed to undermine physicians' commitment to their patient's best interest or to scientific integrity," the authors contend.

A team of American doctors flew secretly to Vienna, Austria, in mid-December to assist in the care of the poisoned Ukrainian presidential candidate, Viktor A. Yushchenko, who later triumphed in an election to become Ukraine's president, doctors involved in the case said recently. The doctors, from the University of Virginia, went at the invitation of the Austrian physicians treating Yushchenko. But the Europeans started consulting other international specialists in toxicology and bioterrorism months earlier, after they became convinced that Yushchenko, who fell ill in early September, was a victim of foul play.

HAVANA - American medical students in Cuba have returned to the United States, missing their final exams, over fears that U.S. authorities will jail them, fine them thousands of dollars or revoke their citizenship for studying medicine on the island. New Bush administration measures that took effect Wednesday severely restrict Americans' presence on the island. The Office of Foreign Assets Control, an arm of the Treasury Department, issued a letter June 25 saying the students could stay until Aug. 1. But many of the students didn't get the word in time.

While most of the 47 million adult smokers in the country say they would like to quit, only 5 percent manage to do so each year. -- American Medical News

Before you reach the articles on anti-coagulation therapy, or echinacea use among children with respiratory infections, or antidepressant-associated sexual dysfunction, you will always see the art. It might be a Van Gogh or a Vermeer or a Cassatt. It might depict the Madonna or tulips or a boxing match. But each week, as you look at the cover of The Journal of the American Medical Association (JAMA), you might feel - just for a moment - like you're peeking through the window of a museum of fine art. "I consider that the heart of JAMA," Dr. Catherine D. DeAngelis, the editor, said of the artwork adorning its covers.

One in 5 adults cannot afford to buy some or all of his prescribed medicines. -- American Medical News

Only two states -- Florida and Washington -- have laws requiring doctors to write prescriptions that are legible. -- American Medical News

Dr. Isadore Kaplan, former medical and surgical director for Chessie System Railroads who was considered an expert in preventive techniques in industrial medicine, died Thursday of complications of an infection at Greater Baltimore Medical Center. The longtime Pikesville resident was 88. Dr. Kaplan began his career in 1946 in the B&O Railroad's medical and surgical department and was appointed medical examiner in 1951. Named the B&O's medical and surgical director in 1958, he was in charge of all medical staff and facilities systemwide.