Letters To The Editors

Soaring malpractice rates: Is arbitration the answer?

Regarding the July 9 cover story about malpractice rates ["Why premiums are soaring again"]: I think everyone needs to know that it's not just bitch time—it's crunch time. The lowest rate I can find from an A-rated company for general surgery is $50,000, and that's with relinquishing vascular and thoracic privileges. Other general surgeons are paying $60,000 to 65,000, or going to a B-rated company.

In my view, the solution must include arbitration. Unfortunately, though, nothing short of a stack of dead bodies will get the attention necessary for meaningful change.

Scott Killmer, MD
Beckley, WVscottkillmer@yahoo.com

Rx for health care: A return to fee-for-service

Your expert panel's analysis of the health care crisis ["American health care: What it will take to fix the system," June 18] misses an essential point: It is impossible to make functional a system that, at its core, is dysfunctional. Medicare and employer-based health care are the diseases, not the cure.

The only salvation for the health care system is to do away with third-party payer plans and return to the quaint concept of having the patient take money from his wallet and pay for what he gets.

Brooks A. Mick, MDHampton, VA

The risks of bond mutual funds

In the July 23, Investment Consult, Lewis J. Altfest does your readers a disservice by suggesting that individual investors add bond mutual funds to their portfolios.

A bond is a contract delineating interest to be paid, principal to be returned, and the date of each. If any of these guarantees is not kept, the bondholder has recourse in court. A bond fund investor does not.

Instead of buying US Treasury Series I bonds to protect against the effects of inflation, as Altfest recommends, investors probably could do just as well—if not better—in terms of total return by purchasing regular Treasuries of various maturities: three months, six months, one year, etc.

I also disagree with the suggestion that, to save money on commissions, investors limit themselves to corporate bonds that trade on the New York Stock Exchange. These make up a very small percentage of corporate bonds currently traded. Going to the exchange may save you a few bucks up front, but it hardly guarantees you'll get the best choice, as selections are severely limited.

Sharon A. Alister
Vice president, Private Client Services
Credit Suisse First Boston
Chicago

Keeping patients—and doctors—happy

Marianne Mattera's editorial suggesting that we need to spend more time with patients ["See two fewer patients," July 9] confirms my feelings and those of many plaintiffs' attorneys. My son-in-law, a plaintiffs' lawyer, is amazed by the high number of patients primary care physicians see each day. He confirms that some of the disasters he's seen were the result of brief and inadequate initial evaluations.

I have given a lot of thought to what would make practicing medicine enjoyable again, please patients, and keep attorneys at bay. If the 30-minute office call were the norm, doctors would have time between visits to give patients that all-important call back. We could keep better records, complete insurance forms in a timely manner, speak to pharmacists—and maybe even go to the toilet. And get home in time for dinner with the family.

Eric G. Anderson, MD
San Diegoeander@san.rr.com

Edited by Gail Weiss,
Senior Editor

Address correspondence to Letters Editor, Medical Economics magazine, 5 Paragon Drive, Montvale, NJ 07645-1742. Or e-mail your comments to meletters@medec.com, or fax them to 201-722-2688. Include your address and daytime phone number. Letters may be edited for length and style. Unless you specify otherwise, we'll assume your letter is for publication. Also, let us know if you don't want your e-mail address printed with your letter.

Gail Weiss. Letters to the Editors.

Medical Economics

2001;17:12.