Nurse Practitioners

Liability limits save access to care Proven medical liability reforms, including a cap on noneconomic damages, are working to keep Maryland physicians caring for patients while still allowing injured patients access to the court system. In fact, as the column from the president of the Maryland trial lawyers association suggests, about the only people complaining are trial lawyers ("Time to treat malpractice victims fairly," Feb. 27). In states without such reforms, many cases result in runaway jury awards for noneconomic damages.

Doctors with Columbia's MedStar Health soon will provide urgent care services at area Rite Aid stores, through a partnership the organizations plan to announce today. Starting this summer, MedStar PromptCare clinics will roll out in four drugstores, two in the Baltimore region and two in the Washington area. The companies hope to add 12 more programs nationwide after studying results of the pilot program. "Health care has been late to having a consumer focus, and consumers are increasingly demanding service in a variety of settings that are much more convenient," said Eric R. Wagner, a senior vice president of managed care for MedStar, a nonprofit.

The number of walk-in health clinics in supermarkets, big box retailers and drugstores has nearly tripled in the past year, leading physicians to wring their hands over quality-of-care issues and bemoan the increased competition for medical services. But physicians at the Greater Baltimore Medical Center have taken a different tack: If you can't beat 'em, join 'em. GBMC, a Towson hospital, agreed to allow physicians it employs to act as off-site medical directors of four such clinics, all newly opened within Target Corp.

Like many thirtysomethings, Sarah Francis is hearing the call of homeownership. With a recent price softening in some markets, the 32-year-old Chicagoan thinks it may be a great time to jump into a condo. She worries about borrowing - she has no credit-card or student-loan debt - and she's managed to accumulate about $40,000 in cash from her income as a nurse practitioner over the past several years, saving money by renting a room at a friend's house. She's also socked away almost $68,000 for retirement.

Michel Zeltzman, a Johns Hopkins nurse practitioner who spent more than 20 years treating brain tumor patients, died of a melanoma Jan. 26 at his Patterson Park home. He was 70. Born in Paris, he learned English on two visits to London, where his mother had relatives. After Paris was occupied by German troops - and the death of his father, Albert, in the Majdanek concentration camp - he lived in the south of France. After Paris was liberated by Allied forces, Mr. Zeltzman returned to Paris.

With a new vaccine on the market to prevent it and multimillion-dollar advertising campaigns highlighting it, the cervical-cancer-causing human papillomavirus - or HPV - might be the most talked-about sexually transmitted disease since HIV. Yet a seven-year-old test designed to detect its most dangerous strains in women still isn't used in 4 out of the 5 gynecological exams it's approved for, according to Digene Corp., the Gaithersburg company that makes the test. And the recent attention to the virus has led other women to request the test when it isn't right for them.

MinuteClinic is closing its six locations at Target outlets in the Baltimore area next month, but opening seven in nearby CVS drugstores. The shift doesn't represent a retreat for the concept of basic-care clinics in retail stores. In fact, it signals the opposite - a jockeying for position as quick clinics enter a period of rapid expansion and increased competition. "As we looked at the future, we believe strategically we will be able to grow quicker through CVS," said Michael Howe, MinuteClinic's chief executive.

Harford Memorial Hospital has begun using a nurse practitioner in the intensive care unit for about half of the unit's evening shifts because of a shortage of critical-care doctors, a move that industry experts said won't necessarily reduce the quality of care. Starting this month, nurse practitioner Peter Lapointe moved from Upper Chesapeake Medical Center, where he had worked about 2 1/2 years in the ICU, to Harford Memorial Hospital, where he will cover about 15 evening/night shifts a month, hospital administrators said.