Examples of academic fraud continue to emanate from the ivory towers of academia attempting to subvert government policy against the public interest and potentially harming the unwary public. The damming case of Michael Bellesiles, who attempted to prove that hunting with guns and gun ownership were rare in America before 1830, perpetrated academic fraud of gigantic proportions on both the annals of sociology and history.
Now we read in the Los Angeles Times that a prominent Bell Labs physicist was fired for faking data on microprocessors. Jan Hendrik Schon's work was said to be poised "to revolutionize his field" in the area of superconductivity and molecular-scale electronics. Instead, a panel of scientists found that the scientist had falsified experiments and misrepresented data over a four-year period.
"It is not possible that this set of curves represent real data, and therefore, this is a clear, unambiguous case of scientific misconduct," the panel concluded. It added that Schon "did this intentionally or recklessly and without the knowledge of any of his coauthors."
According to the panel's report, Schon "stopped short of acknowledging fraud."
"The case represents what some experts say is one of the most egregious examples of scientific misconduct in recent memory, and it is the first case of fabrication at Bell Labs, whose researchers have won six Nobel prizes in physics since the facility's founding 77 years ago," stated the Los Angeles Times' article, September 26, 2002.
By a vote of 217-203, the U.S. House of Representatives passed a bill on September 26, 2000, capping pain-and-suffering damages that juries can award in medical liability suits.
"Our nation is galloping toward a health care crisis of dimensions we have never faced before. There are whole states where a woman cannot find an obstetrician that will take a high-risk pregnancy," stated Rep. Nancy Johnson (R-CT).
Unfortunately, passage of this bill in the Democrat-controlled Senate is uncertain. President George W. Bush is on record as calling for tort reform and supporting limiting large jury verdicts to control the cost of medical liability insurance and stop the drainage of doctors who are quitting their practices or relocating, not only because of rising insurance premiums but also because of the proliferation of frivolous lawsuits. The litigious, adversarial climate in which physicians are forced to practice their profession has, not surprisingly, been detrimental to patients, who are finding it difficult to find qualified physicians.
The legislation limits non-economic damages such as pain and suffering to $250,000. Punitive damages are limited to twice the cost of economic damages awarded or $250,000, whichever is greater.
Democrats insist that the bill "would simply be a cash cow for insurers," according to a report in the Associated Press, "House OKs Malpractice Awards Limit, September 26, 2002.
(See the special issue, "The Medical Liability Crisis and Tort Reform," in the Fall 2002 Medical Sentinel; and Faria, M.A. The litigation juggernaut. J Med Assoc Ga 1993;Aug/Sept. Reprints available from www.hacienda pub.com. Additionally, the reader is invited to peruse my ruminations on this subject in Vandals at the Gates of Medicine, "Physicians under siege," pp. 224-234.)
Breast-feeding may significantly decrease the risk of breast cancer according to the British medical journal Lancet. The study involved 200 investigators reviewing the results of 47 studies involving 150,000 women worldwide.
Among the findings: The risk of breast cancer drops by 4.3 percent for every year women breast feed their babies and by an additional 7 percent for every additional child. These data may explain why Western women who breast feed less have a 6.3 percent chance of getting breast cancer while women in the developing world have only a 2.7 percent incidence.
Women in developing countries have six or seven children and breast feed them for about two years. Western women have on average two or three children and breast feed each for two to three months. The study also found that were Western women to breast-feed for six months or longer, breast cancer rates would drop five percent.
It would appear that breast feeding would convey benefits to nursing mothers in the same fashion that moderate wine consumption would benefit wine enthusiasts by lowering their chances of contracting heart disease.
(Dallas Morning News, July 19, 2002. For more on public health, see also www.ncpa.org/iss/hea.)
Lawyers vs. Patients
More than doctors, it's patients who are the ones being hurt more seriously "by a runaway tort system and sky-rocketing jury awards," according to The Wall Street Journal, May 1, 2002.
Physicians are relocating or quitting all together, making it more difficult for patients to find the physicians they need for the medical care. "The tort system is sending medical insurance costs soaring and causing doctors to quit or move to more practice-friendly states. The average award in the U.S. has gone from $474,000 in 1996 to $1 million in 2000, according to a study by Jury Verdict Research. Payoffs are even higher in such tort-friendly states as Mississippi, known to lawyers as the home of 'jackpot justice.' Mississippi is expected to lose 400 doctors this year, and evidence of the harm to patients can be seen across the country.
"California addressed the problem in 1975 with malpractice reform that caps pain and suffering awards at $250,000 per defendant and sets fees for attorneys."
(See the special issue, "The Medical Liability Crisis and Tort Reform," in the Fall 2002 Medical Sentinel; and Faria, M.A. The litigation juggernaut. J Med Assoc Ga 1993; Aug/Sept). Reprints available from www.haciendapub.com. Additionally, the reader is invited to peruse Dr. Jane Orient's Your Doctor Is Not In, "Malpractice" and "Beyond malpractice: The enforcement of positive obligations," pp. 189-190.)
Violent Crime Rate Continues to Drop
Since 1993, the violent crime rate has fallen precipitously according to government sources. Murder, forcible rape, robbery, aggravated assault have all fallen, and in juveniles, it has accounted for 58 percent of the decline. Since 1993, violent crime has in fact decreased by almost 50 percent.
According to the FBI, the rate of juvenile crime in 2000 was the lowest recorded in the last two decades, although the number of juveniles increased from 27 million to 31 million. In fact, excluding murder, U.S. violent crime rates reached their lowest since 1973, when statistics began to be formally compiled, by the National Crime Victimization Survey, drafted by the Bureau of Justice Statistics. Yet, Americans own more guns than ever before. See also "Violent Crime at 25-year low," Medical Sentinel, March/April 1999.
Conversely, countries such as Great Britain and Australia, which have enacted stringent gun control laws in the last several years, have experienced an explosion in all types of crime because their disarmed citizens have been left to the mercy of armed criminals who do not obey the old or new laws.
(See also Drs. Brown and Faria's articles in Medical Sentinel 2000; 5(3):106-107, http://www.haciendapub.com.)
AAPS released a five-prong defense plan calling for voluntary smallpox immunization that was reported on the front page of NewsMax.com, September 26, 2002, "Doctor's Blast Fed's Smallpox Plan."
AAPS was responding to the federal government's plan to withhold the smallpox vaccine until after a bioterrorism attack causes an outbreak of the lethal and highly contagious disease. This approach, according to AAPS, could lead "to chaos and thousands of preventable deaths."
The AAPS plan advises five immediate steps:
° Make immunizations available, with full disclosure and informed consent, to those who want them. Medical workers, frequent travelers, or people who work in crowded areas or high-rise buildings are among those at risk of early exposure.
° Install high-tech devices, such as electronic noses, in public places such as airports and subways to detect signs of immune system activation in people who are exposed but not yet sick.
°· Stockpile anti-virals now being used to treat AIDS complications and approve emergency off-label use in the event of a smallpox outbreak.
° Disperse vaccines, drugs, supplies and laboratory equipment to local authorities. Total reliance on a centralized system could be disastrous.
The CDC insists that the vaccine is too dangerous for the general public, and yet, paradoxically, youngsters are routinely vaccinated against a myriad of childhood diseases that are less serious and whose vaccines have comparable side effects and potential complications.
According to the Associated Press (September 27, 2002), the Bush Administration is mulling "not whether the public should get the vaccine, but how quickly and under what circumstances."
Moreover, "administration officials say the consensus is to begin vaccinating those at greatest risk of encountering a highly contagious smallpox patient, such as hospital emergency room workers. That could total a half million people. Then the vaccine would be offered to non-hospital health workers, such as primary care doctors, and to police, fire fighters and other emergency workers. At some point after that, it would be offered to the general public."
(See also the special issue, "Bioterrorism in our own backyard," in the Winter 2001 issue of the Medical Sentinel.)
Lawsuits Causing Health Care Costs to Go Through the Roof
Medical liability lawsuits are driving up the cost of medical care according to a new study by the U.S. Department of Heath and Human Services (HHS).
Medical liability is extremely costly to patients, physicians and society. "It adds $60 billion to $110 billion to the costs of private health care each year and another $30 billion to $60 billion to federal government payments for Medicare, Medicaid and other programs."
The study cites medical liability "malpractice" insurance as a primary component of these rising costs: "Excessive lawsuits and massive awards drive up the costs of insurance, which doctors must pass on in increased fees. However, most lawsuits are simply wasteful and benefit trial lawyers more than patients."
Among the findings:
"The vast majority of medical liability claims (up to 70 percent) do not result in any payments to patients, but each of these cases costs almost $25,000 on average to defend against.
"Lawyers' fees account for 40 percent or more of multimillion-dollar payouts.
"Less than 30 percent of all the money that doctors pay in liability insurance fees goes to patients."
The HHS study concludes that states should put "reasonable limits on non-economic damages ($250,000 to $350,000)."
Caps on non-economic damages such as pain and suffering has slowed the rise in insurance premiums in several states. "States without any limits on non-economic malpractice damages are experiencing rises of 44 percent in the cost of insurance on average, while states with limits are experiencing only 12 percent on average."
A summary of this study by the National Center for Policy Analysis (NCPA) points out: "These excessive lawsuits also raise medical costs by forcing doctors to order unnecessary tests to prevent being sued. For example, 79 percent of doctors surveyed admitted that they ordered more tests than medically necessary to help protect themselves against lawsuits. These excessive tests, procedures and prescriptions raise the cost of health care for everyone."
(Source: "Confronting the New Health Care Crisis: Improving Health Care Quality and Lowering Costs By Fixing Our Medical Liability System," July 24, 2002, U.S. Department of Health and Human Services. For HHS study, http://aspe.hhs.gov/daltcp/reports/litrefm.pdf. For more on Litigation Costs, http://www.ncpa.org/iss/leg.)
This edition of News Capsules was compiled by Miguel A. Faria, Jr., M.D., Editor emeritus of the Medical Sentinel of the AAPS. It appeared in the Medical Sentinel 2002;7(4):107-109. Copyright©2002 Association of American Physicians and Surgeons (AAPS).