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An Interview with Herbert Needleman, MD

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An Interview with Herbert Needleman, MD Can a malpractice insurance company be this protective? In a world where insurance companies often choose settlements instead of aggressive defense, The Doctors Company prides itself on vigorously putting your reputation first. That’s why, when plaintiffs filed over 1,000 breast implant claims against physicians covered by The Doctors Company, none resulted in verdicts against the doctors. Protection both comforting and ferocious—what else would you expect from a medical malpractice insurance company called The Doctors Company? More than 10,000 of your California colleagues already know—we’re a national company with local presence, standing ready to serve you. To learn more, visit us on the Web at www.thedoctors.com or call us at (800) 862-0375. 2 SAN FRANCISCO MEDICINE / JANUARY - FEBRUARY 2006 http://www.sfms.org January / February 2006, Vol. 79, No. 1 Environmental Health and Medicine Feature Articles MEMBER SERVICES 4 On Your Behalf 11 The Mainstreaming of Environmental Medicine and Health Philip R. Lee, MD and Steve Heilig, MPH 43 In Memoriam 43 Calendar of Events 12 Toward an Ecological View: Complex Systems, Health and Disease Ted Schettler, MD, MPH MONTHLY COLUMNS 16 Air Pollution and Heart Disease: Recent Developments Michael Lipsett, MD 7 President’s Message Gordon L. Fung, MD 18 Environmental Contaminants and Human Fertility 9 Editorial Linda C. Giudice, MD, PhD, Alison Carlson and Mary Wade Mike Denney, MD, PhD 20 Standing Up to the Lead Industry: 40 Hospital News An Interview with Herbert Needleman, MD 23 Chemical Exposure and Parkinson’s Disease: A Plethora of Suspects Editorial and Advertising Offices Jackie Hunt Christensen and Deborah Cory-Slechta, PhD 1003 A O’Reilly San Francisco, CA 94129 25 The Real Rx: Slow Food, Lively Places, Real Vitality Phone 415/561-0850, ext. 261 Richard J. Jackson, MD, MPH, Megha Doshi and Monica Rai Fax 415/561-0833 Email: [email protected] 27 Choosing Sustainability: Paths to Green Chemistry in California web: http://www.sfms.org Michael Wilson, PhD, MPH San Francisco Medicine reserves the right to 32 Our Stolen Future: A Decade Later edit all reader contributions for brevity, John Peterson Myers, PhD, Dianne Dumanoski and Theo Colborn, PhD clarity and length as well as to reject any material submitted. All expressions of 34 Biomonitoring: Measuring Environmental Contaminants in the Body opinions and statements of supposed facts Davis Baltz, MS are published on the authority of the author over whose signature they appear and 36 Toxicants and Disease Database Update cannot be regarded as expressing the view Sarah Jannsen, MD, PhD, MPH of the SFMS, unless previously adopted by the society. Acceptance of advertising 37 Green Guidelines for Health Care in this publication in no way constitutes Charlotte Brody, RN approval or endorsement of products or services by the SFMS. 38 Methylmercury in Fish: An Update Jane M. Hightower, MD Subscriptions: $45 per year; $5 per issue. Advertising rates and information Of Interest sent upon request. Printing: 39 2005 SFMS Election Results Sundance Press P.O. Box 26605 Tucson, AZ 85726-6605 http://www.sfms.org JANUARY - FEBRUARY 2006 / SAN FRANCISCO MEDICINE 3 January/February 2006, Volume 79, Number 1 N OUR EHALF Editor O Y B Mike Denney, MD A sample of legislation and advocacy activities SFMS/CMA provide for you Managing Editor Edare K. Carroll Copy Editor Cynthia Rubin RETURNABLE FLU VACCINE December. In the meantime, physicians Cover Artist AVAILABLE; IT’S NOT TOO LATE should submit to Medicare claims for Alex Rothwell TO VACCINATE billed charges, rather than billing at 2005 The Centers for Disease Control & or 2006 fee schedule rates. Physicians will Editorial Board Prevention (CDC) have authorized be paid by NHIC, California’s Medicare Mike Denney, Chairman Nancy Thomson, Obituarist Sanofi Pasteur to begin on Friday, January carrier, at the reduced 2006 rates until Stephen Askin Wade Aubry Toni Brayer Corey Maas 6, selling its stockpile of flu vaccine to Congress returns and passes legislation Jaqueline Dolev Jerome Fishgold physicians and others. To encourage reimplementing the higher 2005 payment Alan Greenwald Erica Goode Gretchen Gooding Samuel Kao continued vaccination efforts, and to levels. Thomas Lee Arthur Lyons Rita Melkonian Kenneth Maybury minimize financial risk to physicians, the NHIC will then make appropriate Judith Mates Ricki Pollycove Jordan Shlain Leonard Shlain vaccine is being sold with a return policy. payment adjustments, including possible David Smith Kathleen Unger Physicians will be able to return unused positive retroactive payments if authorized Leo van der Reis Stephen Walsh Shieva Khayam-Bashi vaccine within 30 days for a credit. Flu by the legislation. (It is yet to be vaccine is also available from some determined how these retroactive SFMS Officers Gordon L. Fung, President vaccine distributors, including FFF payments would be disbursed.) Only Stephen E. Follansbee, President-Elect Enterprise (nonreturnable) and McKesson physicians who submit claims for billed Charles J. Wibbelsman, Secretary Stephen H. Fugaro, Treasurer Corporation (returnable). Some charges will be eligible for these Mike Denney, Editor Alan G. Greenwald, Immediate Past President physicians who have extra vaccine for sale retroactive payments. Physicians who bill have also contacted CMA. Contact at the lower 2006 fee schedule will not SFMS Executive Staff Robin Flagg (415)882-5110 or receive retroactive payment increases if Mary Lou Licwinko, JD, MHSA, Executive Director [email protected] for more information. indeed Congress returns physician Steve L. Heilig, MPH, Director of Public Health & Education Edare Carroll, Director of Communications/Managing Editor payments to the higher 2005 levels. Posi Lyon, Director of Administration Therese Porter, Director of Membership CONGRESS FAILS TO PASS Although the 2006 Medicare MEDICARE PAYMENT FREEZE BY participation enrollment period is over, Board of Directors JAN. 1; PHYSICIANS URGED TO CMS has also indicated that it will allow Term: Jan 2006-Dec 2008 SUBMIT CLAIMS FOR BILLED physicians to change their participation Mei-Ling E. Fong, MD Thomas H. Lee, MD CHARGES UNTIL CONGRESS status once Congress has taken action on Carolyn D. Mar, MD STOPS THE CUT the physician payment issue. Rodman S. Rogers, MD John B. Sikorski, MD In mid-December, the U.S. House of Contact: Elizabeth McNeil (415) Peter W. Sullivan, MD John I. Umekubo, MD Representatives passed a federal budget 882-3376, [email protected], for more Term: Jan 2005-Dec 2007 package that would have stopped the 4.4 information. Gary L. Chan, MD percent Medicare cut and frozen physician George A. Fouras, MD Jeffrey Newman, MD payments at 2005 rates. However, the CLARIFICATION ON Thomas J. Peitz, MD John W. Pierce, MD Senate passed an amended budget package PHLEBOTOMY CERTIFICATION Daniel M. Raybin, MD FOR MEDICAL ASSISTANTS Michael H. Siu, MD that had to go back to the House for final approval. Unfortunately, by that time Effective April 9, all persons Term: Jan 2004-Dec 2006 Richard L. Caplin, MD almost all members of the House had left performing phlebotomy in California Lucy S. Crain, MD Jane M. Hightower, MD Washington for the holidays and House must be either licensed or certified in Brian J. Lewis, MD Republican leaders declined to take action order to draw blood for laboratory testing. Michael Rokeach, MD Jordan Shlain, MD on the Medicare physician payment issue. The law does, however, provide an Alan M. Teitelbaum, MD Because Congress did not complete its exception for medical assistants working CMA Trustee Robert J. Margolin work, the Centers for Medicare and in physician offices under the supervision AMA Representatives Medicaid Services (CMS) were obligated of a physician, registered nurse or other H. Hugh Vincent—Delegate by law to implement the scheduled 4.4 licensed healthcare provider. Judith L. Mates—Alternate Delegate Judith L. Mates—AMA’s Women Physicians Congress percent rate cut on January 1. If a medical assistant wants to perform Governing Committee CMA and AMA are working phlebotomy outside a physician office or vigorously to get Congress to pass the clinic, he or she must be a Certified payment freeze that was agreed to in Continued on page 5 4 SAN FRANCISCO MEDICINE / JANUARY - FEBRUARY 2006 http://www.sfms.org Phlebotomy Technician under regulations CHANGE IN CIVIL RIGHTS LAW of the California Department of Health BARS DISCRIMINATION BASED Services. There are three levels of ON MARITAL STATUS certification for phlebotomists: Limited JUST ONE OF DOZENS OF LAWS All SFMS members Phlebotomy Technician (skin punctures), THAT WILL IMPACT PHYSICIANS are cordially invited Certified Phlebotomy Technician I California anti-discrimination law to the (venipunctures and skin punctures), and has been updated to outlaw discrimination Certified Phlebotomy Technician II (skin based on marital status. California’s Annual Dinner punctures, venipunctures, and arterial Business & Professions Code has for years punctures). prohibited discrimination on many Celebrating the Health care professionals—including grounds, including marital status, and installation of our physicians, registered nurses, licensed provided that all invidious discrimination 2006 President vocation nurses, and clinical laboratory could result in a finding of unprofessional scientists—do not need additional conduct. Gordon L. Fung, MD phlebotomy certification to perform skin, The state’s civil rights law, the Unruh vein, or arterial punctures, as they are Civil
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