- Email: [email protected]
Improving work of disciplinary boards
factors that control the expression of biologically active regulatory peptides by cells of the neuroendocrine system will lead to the development of better diagnostic methods and understanding of diseases ranging from gastric ulcers and cancer to diabetes. Prof Lars Inge Larsson will head this project, which has been given DKr 40 million over 5 years. Another of the grants (DKr 30-40 million) will be for a centre for epidemiological research, with its headquarters at Statens Seruminstitut and outlying stations in Copenhagen and Aarhus. The third grant is for work on aspects of biomolecular recognition of DNA. To the institute, the grants come as a highly welcome means of strengthening its research area. Nils Strandberg Pedersen, director of research, also sees the grantswhich are very large by Danish standards-
recognition of the institute’s work. For 2 years the institute has been kept wondering whether it will be privatised. A as a
preliminary decision to do so was made by the previous conservative government. Minister of Health, a Social to be not keen on privatisation. It remains to be seen whether the institute will be totally or only partly privatised, if at all. Meanwhile Statens Seruminstitut continues with its long success at exports, especially of BCG, to several countries, including Eastern Europe and, lately, Latin America. The demand is so great that the institute has
The
current
Democrat, is known
sexual abuse
Kaare Skovmand
clearcut system that brings unithe financing, priority setting, formity and communication aspects of medical research. These measures form part of the government’s attempt to rationalise and ’, increase the efficiency of the organisation of : medical research (see Lancet Sept 18, p734), which is funded, chaotically, from many sources. The amalgamation, thought to be likely to save Dfl 10 million, was recommended in a review on nonuniversity research. The amalgamation is intended to concentrate all research into physical and mental health care under two institutions-one encompassing research into both primary and hospital care, and the other mental, social, sexual, and addictionrelated research.
devise
a
to
Marjanke Spanjer
grown to 1750 pages and 35 000 items.
Pschyrembel is not a typical dictionary. concentrates on a
It selected number of items
and goes into some depth explaining their roots as well as their clinical context and implications. New medical items appear, others vanish. One sadly missed by readers in the new edition is the "Steinlaus" (stone louse, Petrophaga loriota. Discovered by the German cartoonist and humorist Loriot, whose cartoon of it illustrated the entry in the dictionary, the louse was said to have
potential therapeutic impact on gallstones. be excluded this time, an editor explained, because there was fragile evidence of its medical relevance. However, because of popular request, it might appear again in the next edition. It had
to
Annette Tuffs
or
sexual misconduct with
a
patient (173). In only 1974 of the disciplinary actions cited, however, were doctors subjected to serious sanctions, such as the revocation, surrender, or suspension of licenses, being put on probation, or the
Pschyrembel and the stone louse If there is one book every German doctor and medical student has on his shelf, it is Pschyrembel. With its 257th edition the medical dictionary celebrates its centenary in 1994. For more than 90 years the dictionary was edited by just three doctors. It was founded in 1894 as Worterbuch der : klinischen Kunstausdrucke, whose 148 pages contained 5100 items. Its founder, the neurologist Otto Dornbliith, edited and published it until 1922. After his death the general practitioner Emil Bannwarth took over. From 1931 until 1984, 3 years before his death, the Berlin gynaecologist Willibald Pschyrembel, who lent his name to the dictionary, was sole editor for most of the time. Only in the past ten years has the dictionary been edited by a group. It has
A report prepared by a consumer activist group has charged that state medical disciplinary boards and the US government are failing to protect the public from unfit doctors. The report lists the names of 10 289 "questionable" doctors who had been disciplined by state medical boards and federal agencies nationwide in 1992. Among the offences cited for discipline were criminal convictions (1346 cases),
sought permission to set up new production overprescribing or misprescribing drugs : units. (1130), substandard care or negligence (1070), alcohol or drug abuse (817), and
Hitch in Dutch research reorganisation The Netherlands Organisation for Applied Scientific Research and the State Institute for Environmental and Public Health, both threatened by government cutbacks, will not be amalgamating in the near future. Representatives of the two parties and of the Ministries of Education and Sciences and of Public Health could not agree on a formula for the union. The Dutch Cancer Institute has not made up its mind on whether to remain under the Ministry of Public Health or to switch to Education and Sciences. These positions-together with the announcement that the Secretary of State for Public Health is leaving for a post in Rotterdam and will not be replacedmean that major decisions about the reorganisation of medical research might well be postponed until after the May, 1994, general elections. In the meantime several communities and councils are trying to
Improving work of disciplinary boards
restriction or loss of license privileges. The low number of such sanctions, the group
maintains, indicates that less than 0-5% of the nation’s 633 000 physicians need fear serious discipline for misconduct and negligence, despite studies suggesting that 150 000 to 300 000 Americans are injured or killed each year in hospitals alone. The Federation of State Medical Boards of the United States, however, calls the report unfair. If, for example, the report had considered fines, stipulative agreements, letters of chastisement and concern, and other disciplinary actions by boards as serious sanctions, then the number of serious sanctions in 1992 would climb to 2791, said Dale Breaden, a spokesman for the Federation. He added that the report’s emphasis on punishment also overlooks other important work medical boards do to protect the public, such as setting and enforcing licensure standards. According to Breaden the real problem is that medical boards receive inadequate funds because state legislatures keep most of the money collected from medical licensure fees rather than give it to the boards. "This is not about bad boards. We are talking about legislatures that refuse to do their job, refuse to pay attention, until somebody screams bloody murder." So, although the Federation considered the report unfair, Breaden said, it agreed with many of the report’s recommendations, including a call for better state funding of medical boards, more federal grants, and better cooperation between the federal disciplinary agencies and state boards and between the boards of individual states.
Michael McCarthy 1 Wolfe S, McCarthy P, Bame A, McKnew D. 10 289 questionable doctors. Washington DC: Public Citizen Health Research Group, 2000P Street, NW, Suite 600, Washington DC 20036. 1993. $200 ($15 for individual state listing). ISBN 0-93718853-0.
1105
recognition of the institute’s work. For 2 years the institute has been kept wondering whether it will be privatised. A as a
preliminary decision to do so was made by the previous conservative government. Minister of Health, a Social to be not keen on privatisation. It remains to be seen whether the institute will be totally or only partly privatised, if at all. Meanwhile Statens Seruminstitut continues with its long success at exports, especially of BCG, to several countries, including Eastern Europe and, lately, Latin America. The demand is so great that the institute has
The
current
Democrat, is known
sexual abuse
Kaare Skovmand
clearcut system that brings unithe financing, priority setting, formity and communication aspects of medical research. These measures form part of the government’s attempt to rationalise and ’, increase the efficiency of the organisation of : medical research (see Lancet Sept 18, p734), which is funded, chaotically, from many sources. The amalgamation, thought to be likely to save Dfl 10 million, was recommended in a review on nonuniversity research. The amalgamation is intended to concentrate all research into physical and mental health care under two institutions-one encompassing research into both primary and hospital care, and the other mental, social, sexual, and addictionrelated research.
devise
a
to
Marjanke Spanjer
grown to 1750 pages and 35 000 items.
Pschyrembel is not a typical dictionary. concentrates on a
It selected number of items
and goes into some depth explaining their roots as well as their clinical context and implications. New medical items appear, others vanish. One sadly missed by readers in the new edition is the "Steinlaus" (stone louse, Petrophaga loriota. Discovered by the German cartoonist and humorist Loriot, whose cartoon of it illustrated the entry in the dictionary, the louse was said to have
potential therapeutic impact on gallstones. be excluded this time, an editor explained, because there was fragile evidence of its medical relevance. However, because of popular request, it might appear again in the next edition. It had
to
Annette Tuffs
or
sexual misconduct with
a
patient (173). In only 1974 of the disciplinary actions cited, however, were doctors subjected to serious sanctions, such as the revocation, surrender, or suspension of licenses, being put on probation, or the
Pschyrembel and the stone louse If there is one book every German doctor and medical student has on his shelf, it is Pschyrembel. With its 257th edition the medical dictionary celebrates its centenary in 1994. For more than 90 years the dictionary was edited by just three doctors. It was founded in 1894 as Worterbuch der : klinischen Kunstausdrucke, whose 148 pages contained 5100 items. Its founder, the neurologist Otto Dornbliith, edited and published it until 1922. After his death the general practitioner Emil Bannwarth took over. From 1931 until 1984, 3 years before his death, the Berlin gynaecologist Willibald Pschyrembel, who lent his name to the dictionary, was sole editor for most of the time. Only in the past ten years has the dictionary been edited by a group. It has
A report prepared by a consumer activist group has charged that state medical disciplinary boards and the US government are failing to protect the public from unfit doctors. The report lists the names of 10 289 "questionable" doctors who had been disciplined by state medical boards and federal agencies nationwide in 1992. Among the offences cited for discipline were criminal convictions (1346 cases),
sought permission to set up new production overprescribing or misprescribing drugs : units. (1130), substandard care or negligence (1070), alcohol or drug abuse (817), and
Hitch in Dutch research reorganisation The Netherlands Organisation for Applied Scientific Research and the State Institute for Environmental and Public Health, both threatened by government cutbacks, will not be amalgamating in the near future. Representatives of the two parties and of the Ministries of Education and Sciences and of Public Health could not agree on a formula for the union. The Dutch Cancer Institute has not made up its mind on whether to remain under the Ministry of Public Health or to switch to Education and Sciences. These positions-together with the announcement that the Secretary of State for Public Health is leaving for a post in Rotterdam and will not be replacedmean that major decisions about the reorganisation of medical research might well be postponed until after the May, 1994, general elections. In the meantime several communities and councils are trying to
Improving work of disciplinary boards
restriction or loss of license privileges. The low number of such sanctions, the group
maintains, indicates that less than 0-5% of the nation’s 633 000 physicians need fear serious discipline for misconduct and negligence, despite studies suggesting that 150 000 to 300 000 Americans are injured or killed each year in hospitals alone. The Federation of State Medical Boards of the United States, however, calls the report unfair. If, for example, the report had considered fines, stipulative agreements, letters of chastisement and concern, and other disciplinary actions by boards as serious sanctions, then the number of serious sanctions in 1992 would climb to 2791, said Dale Breaden, a spokesman for the Federation. He added that the report’s emphasis on punishment also overlooks other important work medical boards do to protect the public, such as setting and enforcing licensure standards. According to Breaden the real problem is that medical boards receive inadequate funds because state legislatures keep most of the money collected from medical licensure fees rather than give it to the boards. "This is not about bad boards. We are talking about legislatures that refuse to do their job, refuse to pay attention, until somebody screams bloody murder." So, although the Federation considered the report unfair, Breaden said, it agreed with many of the report’s recommendations, including a call for better state funding of medical boards, more federal grants, and better cooperation between the federal disciplinary agencies and state boards and between the boards of individual states.
Michael McCarthy 1 Wolfe S, McCarthy P, Bame A, McKnew D. 10 289 questionable doctors. Washington DC: Public Citizen Health Research Group, 2000P Street, NW, Suite 600, Washington DC 20036. 1993. $200 ($15 for individual state listing). ISBN 0-93718853-0.
1105