Doctors

There's no news that could ever be good news when it comes to the Chris Benoit double murder-suicide. But for those looking for answers as to how someone who was so well-liked and respected by his peers could commit such unspeakable crimes, yesterday's developments might shed some light. Doctors who examined Benoit's brain suggested that repeated concussions could have contributed to the killings. One of the doctors stressed that there is no way to know for sure if the concussions played a role, but the level of brain damage Benoit sustained can cause depression and irrational behavior, he said.

Despite years of effort to curb the number of babies delivered surgically, the nation's Caesarean-section rate has nudged down only slightly. Now, many doctors say it is unrealistic to expect the rate to drop much further and some predict it could even rise.Today, one out of five deliveries in the United States is a C-section, compared to one out of four when the rate peaked in the late 1980s.Obstetricians say the rate remains high for several reasons, including an epidemic of multiple births and an increase in the number of premature and large babies.

Legislation making it a crime to assist a suicide passed the General Assembly yesterday. Gov. Parris N. Glendening is expected to sign the bill and make Maryland the 38th state to explicitly criminalize the practice.The bill passed the Senate 27-20 after days of emotional debate in which opponents argued it would have a chilling effect on doctors' attempts to ease pain at the end of life. Supporters repeatedly referred to Dr. Jack Kevorkian, the Michigan doctor who was convicted last month of second-degree murder in the death of an ailing man who asked to die."

Fine art and classical music -- not exactly what you expect to find at the Fells Point bar Bohager's. But it was the setting for a benefit for Kosovo refugees. Two quartets of Baltimore Symphony Orchestra musicians, and 12-year-old violinist Wei-wei Wang, were among those who serenaded an audience of 200, who also perused and purchased the work of 50 Maryland artists.A moving moment came when Dr. Drew Fuller, an emergency physician at St. Joseph Medical Center, spoke about his recent volunteer stint, working at a Macedonia refugee camp for Doctors of the World, a humanitarian medical relief organization.

NEW YORK -- Two years ago, dozens of teaching hospitals across New York state embraced an unusual pilot program to ease the nationwide glut of physicians. The federal government would pay bonuses to the hospitals if they trained fewer doctors, just as it once paid corn farmers not to grow corn.But half those hospitals have dropped out of the plan after finding that they cannot function without the low-cost labor provided by doctors in training, known as residents.The development, which comes even as the government is planning to expand the New York pilot program nationwide, raises doubts about federal efforts to curb the number of doctors in the nation, and it illustrates a conundrum of health care today.

KUKES, Albania -- A woman who watched as Serbian police slit her husband's throat. A man who was hung by his hands for a day or more. A woman who sobs and won't say why.They would be just three more people who've come over the mountains out of Kosovo and into Kukes, except for one thing -- they've landed in a field hospital that is part of an astonishingly well-equipped camp set up by the United Arab Emirates.The people who run the camp have opted to stay outside the purview of the United Nations High Commissioner for Refugees, and the settlement they've put up here practically gleams.

Maryland Personal Physicians Inc. (MPPI), a company that owns the practices of about 85 doctors and nurse practitioners, filed for bankruptcy reorganization yesterday.That is another setback for the large doctor groups that were formed a few years ago in an attempt to bargain better deals with managed-care insurers. Locally and nationally, several physician groups have filed for bankruptcy or disbanded in the past year.Robert A. Edwards, president of MPPI, said his group will reorganize and try to "emerge from this process a stronger and more focused organization."

BOSTON -- I hope he will forgive another intrusion. There's been quite enough speculation on Joe DiMaggio's health already.The baseball great, who awoke from a coma last month to discover his doctors supplying updates for a media death watch, was appalled. This is not the sort of fame that the Hall of Famer wanted.If rumors of his death were premature, so were recent reports of it. When a news bulletin accidentally crawled across the bottom of a "Dateline NBC" report announcing his demise, Mr. DiMaggio was sitting in a chair watching his life flash before his eyes.

WASHINGTON -- Taking on a significant case on patients' rights, the Supreme Court agreed yesterday to decide whether it's legal for doctors to cut back on treatment to save money for a medical benefits group such as a health maintenance organization.The outcome of an Illinois case may go far toward determining how much protection federal law will offer Americans in the face of cost-cutting efforts by "managed-care" plans.The court, showing a fresh willingness to become involved in sensitive social issues, also agreed for the first time to sort out the rights of grandparents to visit their grandchildren when the parents object.

Baltimore-area physician groups, which came together over the past few years to win and manage HMO contracts, are separating again, as companies that consolidate doctor practices continue to falter.Dr. Richard Maffezzoli, chairman and chief executive of Clinical Associates, said yesterday that his group, with nearly 100 doctors, had bought itself back, splitting off from locally based Flagship Health and its Massachusetts parent, Physicians Quality Care Inc.And Dr. Michael T. Rudikoff, chairman of the steering committee of the 47-doctor Flagship, said his group is also negotiating a buy-back from PQC, and might then regroup as the dozen or so practices that came together to form Flagship.

When Jasmine Cadavid's parents took her to the emergency room near their Abingdon home nearly two weeks ago, the normally playful 2-year-old was lethargic, feverish and struggling to breathe. She not only had swine flu, but her right lung was so filled with fluid from pneumonia that it was getting no air. Soon she was headed to an intensive-care unit at the University of Maryland Hospital for Children, where doctors scrambled to halt the damage; she's still in the hospital, recovering, today.

The small, horizontal scar is barely discernible until Dwan Edwards stretches out his thick, bull neck, as if showing off a medal. This is no medal, though. That scar and what lay beneath cost the Ravens defensive lineman the entire 2008 season and almost his career, all from an injury seemingly so inconsequential that Edwards didn't think he was hurt. The bulging disc in his neck came from a blow to the head in an August preseason game one summer ago. It took five doctors and four months to convince Edwards that surgery was necessary to continue his career.

A 10th person in Maryland has died of swine flu, state health officials said Tuesday. The person, an adult from Western Maryland, had underlying health problems. As with other deaths related to the H1N1 virus, officials would not release further details. Since the outbreak of the virus in the spring, 217 people in Maryland have been hospitalized and two children have died, one of them a 14-year-old girl with no underlying health problems. Nationwide, 81 children have died of the swine flu, according to figures released Tuesday by the Centers for Disease Control and Prevention.

After watching every second of the Peabody- and Emmy Award-winning Hopkins 24/7 and Hopkins documentary series from ABC News, I did not think there was anything that TV had left to tell me about the making of and professional lives of medical doctors. But after seeing the final installment of Nova's 21-year project, Doctors' Diaries, which premieres Tuesday night at 8 on MPT (Channels 22 and 67), I now know I was wrong. It is not that producer-director Michael Barnes finds new emotions, themes or narratives that ABC's Terry Wrong didn't in his brilliant studies of Hopkins and its doctors.

I ran into him in the toothpaste aisle of the local Rite Aid. He was a patient of mine, but I hadn't seen him in a while. I was embarrassed to admit that I couldn't remember his name. Nice guy, about my age, though he appeared to think it was still 1968 with his tie-dyed T-shirt. I had just snagged some dental floss, so I could rack up three or four days of flossing before my visit with the dentist. He took one look at me and said somewhat sheepishly, "Hey, Doc! I gotta see ya soon." (I always wonder, when they call me "Doc," if they don't remember my name either.

Nearly everyone agrees that America's health care system is badly broken. Most people focus on out-of-control costs and lack of coverage: Every year, we spend almost $2 trillion on health care, 16 percent of our gross domestic product. One in six Americans has no health insurance. These are major problems. But another urgent issue gets far less attention. Despite the astronomical costs, our system doesn't provide the right kind of care - even to people lucky enough to have insurance. In short, we're not getting enough for our trillions.

Sarah Price may have had her scrubs on, but she was not prepared to operate. The 6-year-old who won a contest to name the new surgical robot at Baltimore Washington Medical Center in Glen Burnie shook her head vigorously from side to side when the nurse asked her if she wanted to practice using "Poppy". The nurses soon coaxed Sarah to climb into the chair, peer through the viewfinder and thread her thumbs and index fingers through the loops on the fingertip controls. By pinching her fingers together and moving her wrists, she could manipulate the tiny clippers on the arms of the $1.7 million robot to grab rubber loops and place them on small rubber cones.

America's physicians are holding their breath as they wait to see how Washington will resolve the latest mess resulting when the methods of "Madman Muntz" meet Medicare. Earl William "Madman" Muntz was the pioneer pitchman who explained his low prices by saying, "I lose money on every one I sell, but I make it up on the volume." His business model is being tested by Medicare, which tries to keep its budget balanced in response to the increasing number of services that doctors provide by reducing the price paid per service.

Dr. Ronald Sroka has been a family care physician in the same Crofton location for 30 years, just six miles from where he grew up. He's the president-elect of the Maryland State Medical Society, he was voted favorite physician last year in the local Suburban Scene publication, and he counts his high school principal among his many longtime patients. Simply put, Sroka loves what he does. But this is the last year he may be able to afford to do it. Half of his 4,000-client practice relies on Medicare to pay their bills, and Tuesday, a 10.6 percent reduction in Medicare reimbursement rates will take effect unless Congress intervenes.

Turn the tables on your doctors: Do a checkup on them before they conduct one on you. Armed with an Internet connection, you can make sure the medical professionals you're seeing - or considering - are licensed, find out if they have board certification in their specialties, see quality ratings for the hospitals where they practice, get feedback from their patients and weigh in with your own opinions. It's the wired-age version of asking everyone you know for recommendations. "There's an ever-growing appetite for this information," said Scott Shapiro, a spokesman for HealthGrades (healthgrades.