Peer Review

Call it the who's who of legal eagles. It's the Best Lawyers in America, an annual directory that bills itself as a list of top-flight attorneys across 90 fields of practice. And it's no beauty contest, say those who compile and are featured in the directory. The 41,000 names inside are culled from peer reviews of millions of practicing attorneys across the nation. Those listed represent 3 percent of all licensed practicing attorneys in the nation, said Kristen Greer, director of research for Best Lawyers.

In their continuing campaign against animal protein and modern agriculture, the Johns Hopkins University Bloomberg School of Public Health has published findings that, in my opinion as a microbiologist and veterinarian, defy logic and sound science. Their studies examined "chicken feather meal," not meat, and claim from an extremely small sample size to have found trace amounts, in some cases a fraction of one part per billion, of caffeine, arsenic, banned antibiotics and ingredients found in Benadryl, Prozac and Tylenol.

An American worker who feels wrongly treated by a boss is usually given little recourse but to complain to the boss' boss -- an option that breeds frustration and mistrust, says Harvey Caras.So Mr. Caras, a genial 45-year-old Columbia-based corporate consultant, is spearheading what some describe as a revolution in workplace justice.In the last decade, Mr. Caras has sold 334 companies -- ranging from corporate giants like Marriott International Inc. to local employers such as Baltimore's Franklin Square Hospital -- a program he developed that sends worker grievances to juries made up mostly of the workers' peers.

The Maryland Health Care Commission sent recommendations Wednesday to the General Assembly on stepping up oversight of coronary stent placements. They come amid accusations that three doctors were performing unnecessary procedures, but the recommendations were meant to deal more generally with the state's outdated review process for hospitals offering angioplasty and cardiac surgery. Authorities had given some hospitals waivers to offer angioplasty when a patient was having a heart attack, even though the facilities did not have on-site cardiac surgical backup, because research showed it was safe.

On its face, the idea sounds utterly unassailable: Who would oppose a government rule to increase expert discussion of key scientific research? But a new Bush administration proposal to increase peer review for many scientific studies has alarmed public health and environmental groups, as well as many scientists. They call it a back-door attempt to stifle new health and environmental regulations by burying them under mountains of discussion and analysis. Critics contend the process is also designed to produce conclusions slanted toward industry.

ANNAPOLIS -- Certain confidential hospital personnel records may be subject to public scrutiny when they become part of a lawsuit, the Court of Appeals ruled yesterday.The decision, in a case involving The Baltimore Sun and University Hospital, could open to the public the evaluation of doctors by peer review committees, in certain cases.It is only the second time Maryland's highest court has interpreted the state peer review statute, said Mary Craig, a lawyer for the newspapers.The ruling stemmed from an attempt by Kelly Gilbert, who covers U.S. District Court for The Evening Sun, to review the case file in a suit in which Dr. H. Harlan Stone, former professor of surgery at University Hospital, claimed that his rights were violated when he was fired.

The St. Joseph Medical Center cardiologist accused of performing hundreds of unnecessary and potentially dangerous procedures was able to slip through the hospital's safety net of peer reviews partly because, as a department chairman, he could select which cases to evaluate, according to government records. Dr. Mark Midei coordinated all of the peer review at St. Joseph's cardiac catheterization laboratory, which he ran until May 12, 2009, when he was removed on suspicion of placing unnecessary stents in patients' arteries.

Washington.--In these hard times, what's wrong about an ambitious university lobbying in Washington for a couple of million dollars to build a laboratory or a library?Nothing at all, many political traditionalists say, noting that, from sewers to missiles, immense chunks of federal spending are influenced by local interests. That's pork-barrel politics, a pillar of governance dating back to the nation's beginnings. At rates reported to start at $20,000 a month, many universities rely on Washington lobbyists to pursue their dreams on Capitol Hill.

The Maryland Health Care Commission sent recommendations Wednesday to the General Assembly on stepping up oversight of coronary stent placements. They come amid accusations that three doctors were performing unnecessary procedures, but the recommendations were meant to deal more generally with the state's outdated review process for hospitals offering angioplasty and cardiac surgery. Authorities had given some hospitals waivers to offer angioplasty when a patient was having a heart attack, even though the facilities did not have on-site cardiac surgical backup, because research showed it was safe.

A READER HAS kindly pointed out that there is too much tripe on the opposite-editorial page. He is quite right, and I am proud of some of that tripe. But the reader thinks it a problem, and he offers a solution -- peer review.''I am expected to publish as a condition of my employment,'' notes my correspondent, who is a physician. ''When I submit my data for publication, it must undergo the scrutiny of up to four reviewers and an editorial board. . . . There is no assurance that the paper will be deemed suitable for publication.

Regardless of whether Dr. Mark Midei and others may have performed inappropriate stent procedures, the state and Maryland hospitals have not yet agreed to require mandatory accreditation of cardiac cath labs and outside peer review. These were strong recommendations by the American College of Cardiology and the Society for Angiography and Interventions. One year after an investigation by the Health Services Cost Review Commission (HSCRC) was requested, the results are yet to be announced to the public, raising the issue of whether HSCRC is capable of compiling reliable clinical data.

Call it the who's who of legal eagles. It's the Best Lawyers in America, an annual directory that bills itself as a list of top-flight attorneys across 90 fields of practice. And it's no beauty contest, say those who compile and are featured in the directory. The 41,000 names inside are culled from peer reviews of millions of practicing attorneys across the nation. Those listed represent 3 percent of all licensed practicing attorneys in the nation, said Kristen Greer, director of research for Best Lawyers.

The St. Joseph Medical Center cardiologist accused of performing hundreds of unnecessary and potentially dangerous procedures was able to slip through the hospital's safety net of peer reviews partly because, as a department chairman, he could select which cases to evaluate, according to government records. Dr. Mark Midei coordinated all of the peer review at St. Joseph's cardiac catheterization laboratory, which he ran until May 12, 2009, when he was removed on suspicion of placing unnecessary stents in patients' arteries.

Tired of spoiled athletes dominating the headlines? Then you want to hear about Cedric Peerman. Peerman is the University of Virginia running back who was taken by the Ravens in the sixth round of the NFL draft. He has been at the team's minicamp in Owings Mills this week, busting his butt in every drill, accelerating up and down the field like he's turbo-charged. When the 2 1/2 -hour practices are over, he puts in an extra 25 minutes of agility work on a back field. Then, tired and hungry, he comes off the field and patiently does an interview, looking the reporter in the eye and answering each question thoughtfully.

Creative teen-agers are getting more time in the spotlight this year, thanks to a new program designed to celebrate high school theater. Organizers believe a local branch of the Cappies program, in which students review student theatrical productions and vote on awards for outstanding performances (on stage and off), will encourage young writers, motivate actors, singers and stage crew members, and add excitement to the amateur theater experience. "If it's not talked about, it doesn't seem like it's valued," said Carol Lehan, director of the Baltimore Cappies.

On its face, the idea sounds utterly unassailable: Who would oppose a government rule to increase expert discussion of key scientific research? But a new Bush administration proposal to increase peer review for many scientific studies has alarmed public health and environmental groups, as well as many scientists. They call it a back-door attempt to stifle new health and environmental regulations by burying them under mountains of discussion and analysis. Critics contend the process is also designed to produce conclusions slanted toward industry.

Regardless of whether Dr. Mark Midei and others may have performed inappropriate stent procedures, the state and Maryland hospitals have not yet agreed to require mandatory accreditation of cardiac cath labs and outside peer review. These were strong recommendations by the American College of Cardiology and the Society for Angiography and Interventions. One year after an investigation by the Health Services Cost Review Commission (HSCRC) was requested, the results are yet to be announced to the public, raising the issue of whether HSCRC is capable of compiling reliable clinical data.

"The American health-care system is (like a) quartet that has added people to hold the chairs, to hand the violins in, and has required the musicians to stop at the third or fourth page" of "music to call somebody to make sure they can go to the next bar.") -- Hillary Rodham ClintonHillary Rodham Clinton, meet Lee Emerson, of Saint Mary Hospital in Langhorne, Pa. She's one of the beleaguered health-care musicians you described last month in your speech to Congress."There's so much nonsense we have to deal with now," says Ms. Emerson, who supervises patient-care reviews.

A READER HAS kindly pointed out that there is too much tripe on the opposite-editorial page. He is quite right, and I am proud of some of that tripe. But the reader thinks it a problem, and he offers a solution -- peer review.''I am expected to publish as a condition of my employment,'' notes my correspondent, who is a physician. ''When I submit my data for publication, it must undergo the scrutiny of up to four reviewers and an editorial board. . . . There is no assurance that the paper will be deemed suitable for publication.

Washington.--In these hard times, what's wrong about an ambitious university lobbying in Washington for a couple of million dollars to build a laboratory or a library?Nothing at all, many political traditionalists say, noting that, from sewers to missiles, immense chunks of federal spending are influenced by local interests. That's pork-barrel politics, a pillar of governance dating back to the nation's beginnings. At rates reported to start at $20,000 a month, many universities rely on Washington lobbyists to pursue their dreams on Capitol Hill.