Letters

Servium Plan raises insurance questions

To the Editor:

I applaud the approach taken by the authors of "'Insuring' the Uninsured" [September 2004, page 51], but as assistant director of the life and health division of the Georgia Office of Commissioner of Insurance, I offer some words of caution to those contemplating starting their own such program.

In Georgia, a plan very much like the Servium Plan was reviewed by the Georgia attorney general over 20 years ago and found to meet the definition of the transaction of insurance. The basis for that opinion was that the arrangement involved a contract between parties, a consideration, determinable contingencies (the potential need for some services) and risk distribution (where one member's "share" of contributions go to offset another's overutilization of potential services). Those elements worked together to meet the legal definition of insurance and its transaction.

State laws regarding insurance may vary significantly on matters like this, so there may be no problem with the authors' plan in Texas. Doctors may want to check how such a plan squares with the laws that regulate insurance and insurers in their own states.

Tom Carswell
Atlanta

Authors' response:

We are not aware of any insurance regulations that we are violating, nor will we worry about it at this time. This does not imply any disrespect to applicable laws, but if such exist, then perhaps this is the time to bring to the table how these regulations inhibit physicians' ability to address the needs of their patients.

Here in Texas, one in three have no health insurance. While the government and insurance industry try to find a solution, people are dying of preventable diseases and lack of continuity of care. We can either choose to stand idle and hope for the best while people suffer or be proactive in finding solutions that make sense. There comes a time to take a stand for what you believe.

Big praise for big ideas

To the Editor:

The September 2004 "Big Ideas" issue is fabulous! I may not act on all the strategies presented by my fellow family physicians, but it is very interesting and thought-provoking to hear how they have perceived and solved problems.

Dean Center, MD
Bozeman, Mont.

More tips for tablets

To the Editor:

I was very pleased to see your article, "An Introduction to Tablet PCs" [October 2004, page 36]. I have been using them in my office for the past two years. Your article didn't mention what is in my opinion their most useful feature: The pen is much faster than a mouse or touch pad. I mainly use convertible tablets with keyboards. I type while holding the pen under my index finger and over my thumb and middle finger, with the tip pointed at the screen. This way it is very easy to move the pointer/cursor to the exact spot I need to select or type in. I also use the button on the pen to right-click, which especially helps with cutting and pasting. I have even gotten pretty good at pointing and selecting with my right hand while using my left hand to type short numbers or letters or to erase with the backspace key. The pen is much faster than any other pointing device, especially with software optimized for its use. If we really want more physicians to use electronic medical records, both they and the vendors need to know about this new technology.

WE WANT TO HEAR FROM YOU

Send your comments to FPM Letters Editor by e-mail, fpmedit@aafp.org; by mail, Family Practice Management, 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672; or by fax, 913-906-6010. Include your address, daytime phone number and fax number. Submission of a letter will be construed as granting AAFP permission to publish the letter in any of its publications in any form. We cannot respond to all letters we receive. Those chosen for publication will be edited for length and style.

Kerry Stratford, MD
St. George, Utah

Patients may want more than listening

To the Editor:

I started my Lebanese family practice three years ago, applying what I have learned about successful doctor-patient relationships and trying to pass them on to my residents. Overall I'm satisfied with my practice, but I have noticed that while I'm trying to give my patients time to express their fears, feelings and needs, other doctors are seeing a huge number of patients each day, delivering questionable quality of care but receiving high patient satisfaction ratings. As family physicians, we insist on providing high-quality care by listening and sharing information with our patients, but I wonder if patients really want this type of practice. When we apply the basic rules of a good interview we are satisfied as doctors, but it seems it is not enough for our patients.

Grace Abi Rizk, MD
Beirut, Lebanon

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