Judge Rules for Journals
A federal judge in Chicago last month ruled that JAMA and the Archives of Internal Medicine do not need to release documents related to the confidential peer review process for studies on cyclooxygenase-2 inhibitors. Attorneys for drugmaker Pfizer Inc. had issued subpoenas last year to obtain all documents relating to the decision to accept or reject manuscripts, copies of rejected manuscripts, the identities of peer reviewers and their comments, and editors' comments regarding manuscripts, peer review, and publication decisions. But U.S. District Court Judge Arlander Keys of the Northern District of Illinois ruled that the journals can keep the documents confidential. “It is not unreasonable to believe that compelling production of peer review documents would compromise the process,” Judge Keys wrote. Dr. Catherine DeAngelis, JAMA's editor-in-chief, and JAMA's editorial counsel, Joseph Thornton, wrote in an online editorial released March 24 that the ruling supports the confidential peer review process. “For months, JAMA and [Archives of Internal Medicine] consistently argued that the sanctity of the confidential peer review process should not be violated,” they wrote. “JAMA and our Archives journals have historically and deliberately kept unpublished manuscripts and peer review comments confidential. This promise to reviewers and authors allows the peer review process to work in an unrestrained environment.” A federal judge in Boston has not yet ruled on a similar request by Pfizer to force the release of documents from the New England Journal of Medicine.
Primary Care Survey Planned
The Physicians' Foundation for Health Systems Excellence is seeking to gain insight into the state of primary care through what it says is one of the most ambitious physician surveys ever attempted. Beginning next month, the group will send more than 300,000 surveys to primary care physicians and selected specialists—virtually every active primary care physician nationwide —and to specialists in small, independent practices, according to the group. The survey will ask about the state of primary care practices, and whether or not physicians can maintain patient care services in light of current regulatory and financial burdens. “If the survey indicates that medical practice itself is in jeopardy, that urgent message needs to be heard by policy makers and the public,” said Dr. Walter Ray, vice president of the Physicians' Foundation and former president of the Medical Association of Georgia, in a statement. The group has partnered with national physician search and consulting firm Merritt, Hawkins & Associates to develop and mail the survey.
FDA to Establish China Offices
In the first step to establishing offices in China, the Food and Drug Administration has received approval from the State Department to create eight full-time permanent FDA positions at U.S. diplomatic posts there, pending authorization from the Chinese government. In addition, the FDA said, it will be hiring five Chinese nationals to work with the new FDA staff at the U.S. Embassy in Beijing and consulates in Shanghai and Guangzhou. The offices will allow greater access for inspections and greater interactions with manufacturers to help assure that products that are shipped to the United States meet U.S. standards for safety and manufacturing quality, the FDA said.
Well-Insured Sent to ASCs
Physicians at physician-owned ambulatory surgery centers are more likely than other providers are to refer well-insured patients to their facilities, while routing Medicaid patients to hospital outpatient clinics, a study in Health Affairs found. The study looked at ASCs in the Philadelphia and Pittsburgh metropolitan areas in 2003. Procedures studied ranged from the removal of benign skin lesions to procedures dealing with hand and wrist disorders such as carpal tunnel syndrome. For most ASCs, the largest common diagnostic groupings were cataract surgery and gastrointestinal disorders and testing, including colonoscopy and endoscopy. The study reviewed the referral patterns of the physicians who accounted for the top 50% of patient referrals to physician-owned ASCs and found that these physicians were significantly more likely to refer Medicaid patients to hospital outpatient departments. The study authors noted that some lawmakers are concerned that continued growth of ASCs will “contribute to a further unraveling of an already fragile safety net. The worry is that physician-owned facilities will siphon off profit centers that have traditionally cross-subsidized care for uninsured and Medicaid patients, as well as unprofitable services such as burn treatment. The findings from this paper are consistent with that fear.”
Lottery to Determine Coverage
More than 91,000 Oregonians have signed up for a lottery to determine which uninsured state residents will receive coverage under the Oregon Health Plan, which covers Medicaid-eligible patients and others in the state who can't get coverage, the state's Department of Human Services said. Of the 160,000 uninsured Oregon residents, about 130,000 qualify for the Oregon Health Plan, but the state can afford to cover only up to 24,000 members. Right now, the plan has 17,000 members, and state officials decided that the fairest way to determine who else would receive coverage would be to hold a lottery. Only about 3,000 of the initial 91,000 lottery entrants will receive applications for the health plan, and the state will distribute more applications in batches of 3,000 until program enrollment reaches 24,000, according to the state DHS.