Letters -- July 1999 -- FP Report

FP Report -- July 1999

Letters

More smoking letters

To the editor:
Certainly I am in great and emphatic agreement with your correspondents, Drs. Douglas Lewis and Lance Monroe (writers of letters in the April FP Report). I am opposed to the AAFP stand of support for President Clinton and Janet Reno on the tobacco question. It is one more shameful chapter of this Clintonian degraded age. These suits are one more example of the impudent dominance of the law profession. ...

The truth is that the tobacco (based on the truth that it is a harmful substance) question is just another "gold mine" (not unlike the abuse of malpractice cases by greedy patients and lawyers) for the opportunistic law firms (billions of dollars -- daylight legal robberies). ...

For over 30 years, American medicine has yielded to the manipulations of legal forces in our society and has not really established a platform from which this evil can be thwarted.

E. JED JOHNSON, M.D.
Marseilles, Ill.

To the editor:
The April FP Report included letters criticizing the AAFP support of legal action against the tobacco industry. I could not disagree more with these two fellow doctors. I agree people should be held responsible for their own decisions. However, business leaders and corporations should also be held responsible for their actions.

For 40 years, the tobacco industry has lied to the world regarding the degree to which smoking causes disease and death. ... In 1994, they lied under oath before Congress, stating, "Nicotine is not addictive." The industry has financed faulty research to cast doubts upon studies showing tobacco's link to disease. Imagine a doctor, a hospital or pharmaceutical company lying about the health risks of a certain drug -- let alone an addictive drug.

I fail to understand why some people remain reluctant to apply the same ethical standards to the tobacco industry as we apply to other professions or businesses. Finally, kudos to the AAFP for recognizing this disparity and supporting legal efforts against the tobacco industry.

MICHAEL PRAMENKO, M.D.
Grand Junction, Colo.

Drop in match

To the editor:
The decline in (residency) matching numbers is likely multifactorial (see "Match Trends Show Decline for Second Year," AprilFP Report). Having been in practice since 1974, and having survived many hassles, including managed care, government programs and competition from nonphysician providers, I respectfully offer this commentary. The factors decreasing the match numbers include the following:

student awareness of attitudes of disdain for the concept of family practice, sometimes shared by some medical school specialists and specialty residents;

known salary or income disparity compared to other specialties (we have all known about this, and it may be a nonsignificant factor, but I don't have data on this issue); and

known competition from nonphysician providers, who have become quite numerous in some areas, including already well-doctored areas. This acts in effect to decrease the availability of job offerings for a physician. For example, Dr. Jones is very busy, so instead of associating with another M.D. or allowing patients to go to a newer and less busy M.D. in the area, they hire a nonphysician provider to work in their office. This scenario is repeated frequently. ...

RICHARD D. GAGE, M.D.
Boise, Idaho

Where was AAFP?

To the editor:
"The Ganske bill was the first patient rights bill the AAFP has ever supported" (from the May FP Report). Amazing!

When the new mothers and their children and families cried out for protection from the premature discharge policies of the insurance industry, I guess the AAFP was nowhere to be found. ...

I think that the membership of the AAFP deserves to know where the candidates for leadership stand on the key issues. Why can't the membership have a direct vote -- one person, one vote? Why do we have all these complicated processes? Why can't the organization give us a position paper for each candidate, tell us where they stand and let us vote directly? ...

We need a union, and we need one now. ...

THOMAS E. McNAMARA, M.D.
Elk Grove Village, Ill.

FP Report is published by the AAFP News Department. Copyright © 1999 by American Academy of Family Physicians.

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