Von Eschenbach Confirmed for FDA
Almost 9 months after he was first nominated to be Food and Drug Administration commissioner, Dr. Andrew von Eschenbach was finally confirmed by the Senate by an 80–11 vote in the wee hours of the 109th Congress. Confirmation came after an 89–6 vote to limit debate on his nomination. The naysayers included Sen. Chuck Grassley (R-Iowa), one of Dr. von Eschenbach's most vocal critics. As Finance Committee chairman, Sen. Grassley and his staff have been investigating what they call an inappropriate approval of Ketek (telithromycin). Sen. Grassley maintains that Dr. von Eschenbach has stonewalled committee investigators, and in an agitated floor statement during the nomination vote, he accused the nominee of hiding documents and intimidating FDA employees who dissented. Sen. Grassley warned his colleagues that Dr. von Eschenbach was a prime illustration of concerns about the lack of Senate oversight of the Bush administration. “I believe we need to send a message to the executive branch that it's not okay to impede congressional investigations. It's not okay to limit the Senate's access to documents, information, and employees of the executive branch,” the senator said.
AMA Joins Washington Lawsuit
The American Medical Association has joined six Washington state physicians and the Washington State Medical Association in a lawsuit against Regence BlueShield asserting that the insurer used faulty internal quality data in excluding nearly 500 physicians from a new network that Regence is developing. “This lawsuit has repercussions far beyond Washington state as more health insurers impose financial disincentives which threaten to disrupt patients' longstanding relationships with physicians they know and trust,” AMA Past President Edward J. Hill commented in a statement. The lawsuit, filed Sept. 21, stems from Regence's decision to create a “select network” of physicians who deliver “high quality, efficient care” to serve mainly Boeing Co. engineers. The lawsuit contends that the methodology Regence used to calculate performance failed to consider the population of patients seen by the physicians; used small samples and inaccurate records; and included patients who should have been excluded “because of their personal medical histories.”
Med School Enrollment on Rise
The Association of American Medical Colleges reports that U.S. medical school enrollment for 2006 increased by just over 2% to 17,370. Some schools posted even greater gains, among them: Florida State University (36% increase), Brown University (25%), Boston University (15%), Saint Louis University (15%), Pennsylvania State University (13%), Wayne State University (11%), West Virginia University (11%), Drexel University (10%), and the University of Alabama, Birmingham (10%). There was an almost 5% increase in applicants in 2006, to 39,109. There were almost equal numbers of male and female applicants (19,812 and 19,297, respectively) and enrollees—8,924 men and 8,446 women. There was a 9% increase in the number of accepted black applicants and an 8% increase in the number of black enrollees. “With the looming doctor shortage, these results are good news indeed, and we hope this encouraging trend continues,” said Dr. Darrell G. Kirch, AAMC president.
Health IT Have-Nots
The adoption gap in health information technology continues to widen, with physicians in smaller practices being left behind, according to a report from the Center for Studying Health System Change (HSC). Compared with 2000 and 2001, in 2004 and 2005 physicians in all types of practices increased their use of health IT for accessing patient notes, generating patient reminders, exchanging clinical data, accessing guidelines, and writing prescriptions. However, practices with 1 or 2 physicians increased their use of health IT for writing prescriptions by 5%, compared with 28% among practices with more than 50 physicians. The gaps are likely because of the greater financial and administrative resources of larger practices and economies of scale. Large practices also may have an advantage in adoption because they have more active physician leaders who are promoting IT and quality improvement, according to the report. The data in the report are from the HSC Community Tracking Study Physician survey, a nationally representative telephone survey of physicians who are involved in direct patient care in the United States. “Larger practices appear to be gaining critical mass in adopting IT for patient care, but the smallest practices, which account for more than half of all practicing physicians, appear to be at risk of being left behind,” Joy M. Grossman, senior health researcher at HSC, said in a statement. The report is available online at
Omnicare Settles Drug Overcharges
Covington, Ky.-based Omnicare, which provides pharmacy services to nursing homes, has agreed to pay the federal government and 43 states $49.5 million to settle claims that the company overcharged Medicaid. The suit was filed by two whistle-blowers, who alleged that from 2000 to 2005, Omnicare was switching patients from cheaper to more costly versions of three drugs—ranitidine, fluoxetine, and buspirone—to inflate profits. In most cases, the company was substituting capsules for tablets or vice versa. Physicians either weren't aware of the switches or were falsely told that the substitution would cost less. The settlement was filed in U.S. District Court for the Northern District of Illinois in Chicago; Omnicare admitted no wrongdoing.