Letters
Issue Calls for Reasoned Discussion, Not Politics
I would like to respond to my colleagues Dr. John Wagner and Dr. Meri Firpo, who wrote the article “Stem Cell Research in Minnesota Here Today, Gone Tomorrow?” (May, p. 34). These authors are experts in their fields, and I respect them. But I object to their characterization of those who oppose the type of research they want to do, that is, research involving embryonic stem cells and somatic cell nuclear transfer. Their comments were politically charged and not helpful. We need, instead, to have a reasoned discussion about closing objectionable avenues of research. Such a discussion ought to include consideration of these issues:
- The ethical considerations of doing research on the cells created by somatic cell nuclear transfer. Somatic cell nuclear transfer results in a cellular human being. But it is classified as a thing and is, therefore, used by other people for their own purposes. We need to remember that the Nuremberg trials were not held to determine whether research that doctors under the Nazi regime did was promising nor if it had the potential to help ill people. It was held to determine if the subjects of the research had been properly treated and whether informed consent had been obtained from them. Since then, the international community has worked to ensure that research is conducted with adequate respect for the rights of the human test subjects.
- The evidence on the potential of adult stem cell therapies. Recipients of adult stem cell therapies have testified before Congress about their effectiveness in treating spinal cord injuries, diabetes mellitus, and bone marrow diseases.
- The fact that use of embryonic stem cells has thus far resulted in no cures for any diseases. Embryonic stem cell research has yet to result in cures, yet funding from government and private sources has not been meager.
This commentary characterized those who oppose stem cell research using embryonic stem cells and somatic cell nuclear transfer as a vocal minority. It ignores the fact that many who are in this camp have come to this position after looking at the research and wrestling with tough ethical questions. We need to allow discourse about an issue as important as this to continue, and we need to avoid characterizing people with opposing views as undiscerning. We need to do the right thing.
James J. Joyce, M.D.
Sleepy Eye, Minnesota
A One-Star Doc Responds
Like Dr. David Thorson (April Viewpoint, p. 18), I am a “one-star doc” as determined by the Medica Premium Designation program. I received my one star for “quality” (whatever way that was measured) but failed on “cost.”
After enlisting my overworked staff to sort through the patient information gleaned from the Medica website and pull the corresponding charts, I began to wade through the information about the 28 patients who exceeded the expenditure “norms” for my specialty. It quickly became obvious that the reason I lost my cost star was because of coding errors made by Medica. For example, I found that for several patients, Medica assigned incorrect diagnostic codes to their problems. In other cases, Medica assigned only one diagnostic code when the patients’ expenses were generated by more than one problem. These coding errors were made despite the fact that I had submitted the correct codes.
I, and others no doubt, am being doubly penalized by Medica. First, I have been labeled by a major third-party payer as too expensive based on their flawed data. Second, to correct the mistake caused by Medica’s own incompetence, I am required to fill out and submit “reconsideration requests” for each patient. These insults are further magnified by the fact that this misinformation is made public for all Medica subscribers to see. Would you go to a one-star doc when there are others with two stars?
Although the MMA has registered its displeasure with this flawed program, I do not see any evidence that the MMA or any of our other medical societies that are supposed to be looking out for our welfare have done anything more than stage a token protest about this unfair and onerous program. Thorson concludes that the “MMA will continue to monitor this issue and press Medica to fix the flaws in its system.”
I think that this is not enough.
Jack E. Hubbard Ph.D., M.D.
Neurologist, Burnsville