Two members of the UCD faculty recently published an article about preferential admissions in the October 8 issue of JAMA. Profs Robert Davidson and Ernest Lewis reported that their 20-year study proved that preferential admission policies are harmless–that they do not affect the quality of the doctors who graduate. Gail Heriot, a law professor at the University of San Diego reported in the Wall Street Journal that there was just one small problem: their study’s data support the opposite conclusion. An editorial in the same issue of JAMA called for preferential treatment as a means of restoring trust to the medical profession. Professor Heriot said that JAMA editors should be concerned about trust. When doctors are torturing data to make a political point, whom can you trust? … To which we might add that there is a serious problem of equal opportunity for the disadvantaged and some minorities. But let’s interpret the problem correctly and then look for an appropriate solution.

Employees at Oxford Health Plans Inc had just received their first stock options at an exercise price of over $70 a share. Some employees bought their shares on margin–borrowing money to make the purchase–and one postponed her wedding to become a part of this revered managed care company. But on Bloody Monday, the tenth anniversary of Black Tuesday, their stock dipped to slightly over $25 a share. On Sunday evening when Oxford CEO Stephen Wiggins called in the managers for a meeting, they knew something was wrong. One manager stated that he felt like he had been hit in the back of the head with a bat. Some employees had heartburn while others just felt ill. The whole “HMO Feels Sick” according to headlines in the Wall Street Journal. Although the CEO had a paper loss of $115 million, he had already sold enough shares at $70 recently to put $15 million in his bank. Should be enough to get him through a wet spell while the doctors continue to save costs to replenish his paper losses.

Trial lawyers rush to turn the diet-pill ills into money in the bank. One disaster chaser has run ads, hit the talk show circuit, and written legal articles in an attempt to cash in on a “business opportunity.” The “Fen-Phen Litigation Group” was formed at an Association of Trial Lawyers of America meeting. Other critics say such lawyers are in it for the greater good of their bank accounts, not of their clients. The trial lawyers respond that this is the reality of the legal marketplace and they are capitalizing on just another business opportunity.

The California Trial Lawyers Association has taken the lead in changing its name to the Consumer Attorneys of California. This image enhancer should be easy to remember: CACA.

A week after the alarming 32% incidence of heart valve abnormality in 291 patients taking “Fen-Phen” was published, the Wall Street Journal surveyed 21 other medical sites across the country and found an incidence of 8% in 750 patients studied. Some sites had studied as many as 25 patients without finding a heart problem and others studied 50 with only one “leaky valve.” Others have stated the 8% incidence may be an acceptable risk for severely obese people with a high incidence of diabetes, hypertension, and heart disease with a greater combined risk. They feel the problem was that “Fen-Phen” was prescribed for the marginally overweight. The WSJ wonders whether the FDA and American Home Products Corp, which markets Redux and Pondimin, might have acted prematurely in withdrawing the drugs. The WSJ felt that perhaps they should have waited another month for the meeting of the North American Association for the Study of Obesity meeting. Maybe if we start doing a large series of echocardiograms on normal people, we will find a small incidence of valvular abnormalities in asymptomatic people. Remember when we started doing chemistry panels some 25 years ago and found a lot of people had elevated uric acids who never had gout? Do you suppose we could get Oxford Health to pay for a few thousand screening echocardiograms to document the real risks?