Medical Care Industry

Calling Gov. Arnold Schwarzenegger's healthcare plan a giveaway to insurers, Democratic lawmakers and some advocates will renew their effort today to replace the entire industry in California with a government-run health plan. Commonly called "single-payer," the proposal was approved by the Legislature last year but vetoed by Schwarzenegger.

The Food and Drug Administration said Wednesday that it would bar outside medical experts with a financial interest in a manufacturer from voting on advisory panels assessing whether drugs or other products made by that company are safe and effective. The proposed restrictions -- which would also apply to experts with ties to competing firms -- would significantly strengthen the FDA's conflict-of-interest policy.

On April 18, the U.S. Supreme Court upheld the federal Partial-Birth Abortion Ban Act of 2003. It bans a type of abortion often referred to as "partial-birth abortion" and serves up two years imprisonment and/or a fine for anyone performing the procedure. It is legal if the woman's life is in danger, but can't be done just to protect her health.

Researchers are developing a potential new weapon in the battle against obesity: training pediatricians and dietitians in a special interviewing technique designed to motivate parents of overweight kids to make healthy changes in their family lifestyles. The technique, motivational interviewing, involves asking open-ended questions (for example, "Could you tell me how you feel about your weight?").

It's only Thursday and already I'm beat. As usual, I'm swamped: phone calls to return, charts and labs to review, all sandwiched between my regular schedule of patients. I love them, but the frenetic pace wears me down. There is hope in sight: On Thursdays, the drug reps cater lunch. They roll out the red carpet, flatter and regale me with all sorts of impressive-sounding scientific studies, all showcasing their drug.

Likened to "body snatchers" by Orange County's top prosecutor, three doctors were arrested Wednesday for their alleged roles in an elaborate insurance fraud scheme in which hundreds of patients across the U.S. were recruited to undergo unnecessary procedures in exchange for money or low-cost cosmetic surgeries. The arrests bring to 17 the number of people named in the "rent-a-patient" scam allegedly operated out of Unity Outpatient Surgery Center in Buena Park. Michael C.

IN the midst of criticism of America's healthcare system over the last decade, Americans held fast to the belief that if you have to be sick, this country is the best place to be. Faced with casual comparisons with Canada or Europe, many were ready with counterarguments: Americans don't have to wait months for bypass surgery, like they do in Canada. Doctors here aren't constrained by government interference.

RECENTLY, managed-care insurance companies have been increasing their pressure on me and other doctors to change patients over to generic alternatives to some of our most popular drugs. On the surface, this would appear to be a good idea, one that saves money and thus should be a primary consideration when prescribing drugs. Sometimes it is -- but not always. It had taken me several years to convince Roger to take Lipitor (atorvastatin), a cholesterol-lowering medication.

Electronic health records -- touted by policymakers as a way to improve the quality of health care -- failed to boost care delivered in routine doctor visits, U.S. researchers said last Monday. Of 17 measures of quality assessed, electronic health records made no difference in 14 measures, according to a study published in the Archives of Internal Medicine. It was based on a survey of 1.8 billion physician visits in 2003 and 2004.

Even in this digital age -- when one can get the temperature in Kuala Lumpur or the Zuma Beach surf report at the click of a button -- most people still rely on word of mouth to pick their doctor or check up on their local hospital. Others choose from lists provided by their health plans, cross their fingers and, well, hope for the best.