Faculty Bibliography

In part it is the sleepless nights that form a doctor's mettle. Essential skills learned under military-type rigor are not soon forgotten and are essential to good doctoring. And many specialties require emergency middle-of-the-night calls throughout a doctor's career--it is the on-call shift that prepares a young doctor for the later demands of practice. A greater concern than hours is supervision. Eighteen years ago in New York a young woman named Libby Zion was diagnosed and treated improperly because of inadequately supervised--not sleep-deprived-- residents. She died. The result of this case was New York's laws to limit residency hours, yet adequate supervision, the real problem, was not ensured. This year, an undertrained doctor at a New York teaching hospital was left in charge of a ward of sick liver transplant donors and recipients, and a liver donor died

Marc Siegel comments on caring for a hospitalized patient with heart disease without ever having met her face to face.

Over the past five years the drug companies have struggled to create name recognition using extensive television and magazine ads. The major effect of this has been to raise drug prices and overall costs as patients pressure doctors to prescribe drugs that often aren't needed. A report from UCLA last year concluded that doctor/patient roles may be damaged

The House recently passed a $4.6 billion bill that arranges for sprucing up CDC facilities and bringing the CDC to the forefront of the bioterror response. Further, the bill addresses the need for a rapid gearing-up of hospitals and laboratories throughout the country in the event of a catastrophe. But even if the overseeing agencies modernize their equipment and change their orientation toward terror, the FBI still is not in the business of public health. And the public-health-oriented scientists of the CDC, no matter how many computer links and sparkling new bioterror labs they get, still are not accustomed to being leaders at a time of crisis

Medicare has always provided compensation for 80 percent of what it sets as the bill, an amount that, if no longer gilded, still compensates doctors adequately. And as long as it pays the bills, Medicare is preferable to the strictures of most health maintenance organizations. It allows us to choose what tests we order and to refer our patients to specialists as we think is necessary. For doctors, Medicare is usually free of the problems that plague many H.M.O.'s -- the excess paperwork, the referral requests, the insurance-company arbiter who has the power to deny essential tests. With Medicare covering 80 percent of the bill, the greater difficulty often lies in collecting the remaining 20 percent from the patient or his secondary insurance

In October, when the first anthrax-laden envelopes were received, the FBI froze the Centers for Disease Control and Prevention out of the high-profile investigation, according to CDC officials. The US safety net against bioterror was porous because of a turf battle initiated by FBI autocrats, and five people died.

Muhammed Butt's death from a heart attack illustrates a central problem that is the direct consequence of a zealous backlash against terrorism--the detention of hundreds of people without justification and for prolonged periods of time. Butt is profiled, and his unjust detention for being a suspect in the anthrax attacks on America is discussed

Bayer, the manufacturer of Cipro, is stoking frenzy and playing into public hysteria by promoting the drug. What the drug company is not telling anybody is that Cipro was originally tested as an alternative treatment for anthrax only for penicillin-allergic patients, and a generic is just as effective and costs one-tenth of what Cipro costs.