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Sunday, November 13, 2005
The Oregonian

Health systems must improve oversight of physicians


The Nov. 6 front-page article "Patel's disturbing record at Kaiser stayed hidden for years" proved as much an indictment of our flawed health care system as it was an expose of a dangerous, arrogant surgeon.

When health plans tell their members to be "better health care consumers" and shop for providers with the best health outcomes (and best pricing), it is a laughable proposition given the lack of transparency into a physician's track record, as described in the article.

And when physicians bemoan the cost of their malpractice insurance and plead their case to voters with tort-reform ballot measures, we would do well to remember the Dr. Patels of the profession who practice, seemingly, with a license to kill, owing to the lack of oversight by the profession.

One would think that physicians would support a system whereby the worst practitioners would be readily identified and required to pay higher malpractice premiums, if not forced out of the profession altogether. Physicians, police thyselves!

PAUL TYO Tigard Many say health providers violated public right

As a current and 53-year member of Kaiser Permanente Northwest, I am outraged by The Oregonian's expose of the failure to report malpractice lawsuits, deaths and harm that have befallen members of Kaiser, Legacy Health Systems and Oregon Health & Science University ("Patel's disturbing record at Kaiser stayed hidden for years," Nov. 6; and "State let Kaiser, OHSU escape oversight," Nov. 7).

The secrecy strikes fear into the hearts of members who rely on their physicians to provide quality care and services for their well-being. Dr. Jayant M. Patel's negligence reflects negatively on all physicians.

Now is the time for the governor and the Legislature to mandate reporting of all malpractice claims to the state with the names, outcomes and any financial settlements. All previous claims should be disclosed, retroactive for the past 20 years.

The state Board of Medical Examiners was negligent in its regulatory function. The board's charge is to oversee the quality of care delivered by licensed physicians. It appears that the board defends the physicians more than patients' lives. It is time for some housecleaning at the Board of Medical Examiners, with new membership and a new director.

DOLORES HUBERT Northeast Portland

Thanks to your reporters for their story on the abrogation of public interest and patient safety by Oregon's trusted medical institutions for 18 years ("State let Kaiser, OHSU escape oversight," Nov. 7).

At these institutions, the code of silence has trumped "first do no harm."

The managers of these institutions during the period should be prosecuted to the fullest extent of law as an incentive to current and future managers. Fining the institutions [would] merely raise the cost of health care.

Public officials who connived with them also should be prosecuted to help restore public trust in the relevant state institutions.

TOM SHILLOCK Southwest Portland

I am a physician with Kaiser, and I am expressing my personal opinion. I have a different view of the facts presented in your series on malpractice.

The history is complex, but it boils down to this: In 1991, the Legislature passed an ambiguous amendment to a malpractice reporting act that exempted Legacy from reporting, and allowed Kaiser and OHSU to claim the same exemption. They ceased reporting malpractice among their physicians to the state Board of Medical Examiners, which was not even aware that Kaiser and OHSU were not reporting.

In 1998, Kaiser successfully limited the practice of an incompetent surgeon. The Oregonian wrote a series that detailed the pain and horror of each injured patient, and implied that Kaiser was at fault because it did not report to the Board of Medical Examiners, and the board would have acted more swiftly.

However, when Kaiser reviewed the surgeon's record, it took Kaiser five months to restrict the surgeon's privileges. When the Board of Medical Examiners was notified of this action, it took two years to discipline the physician.

The Legislature wrote the law poorly, and the Board of Medical Examiners is underfunded, overworked and slow. It is clear that the state could not have acted with the speed that Kaiser took in limiting this surgeon.

Kaiser should be praised for protecting its patients, not condemned.

STEPHEN BACHHUBER, M.D. Southeast Portland

It is totally disgusting to me that Kaiser and OHSU (and others) would look for every loophole they could find to keep the public from knowing about dangerous doctors.

Doesn't your Nov. 7 article's statement that "evidence had mounted that state boards were allowing dangerous doctors to keep their licenses, provided they quietly resigned and moved elsewhere" ring a bell?

That's the same mind-set that let pedophile priests continue to victimize over and over again. Absolutely inexcusable.

RUTH NEWBREY Southwest Portland

The reporting of the tragedy surrounding Dr. Jayant M. Patel was good work. The Board of Medical Examiners is more concerned with political misfits within the medical profession than it is with bad patient care.

The failure of the medical profession to adequately police itself makes us realize the importance of juries in evaluating poor medical care. When will the secrecy surrounding the medical profession, and the good ol' boy network, give way to the sanitizing effects of daylight and public scrutiny?

JEFF WIHTOL Southwest Portland

Tortured logic

From Abu Ghraib to secret prisons in the former Soviet Gulag, we have quite a little discussion going on these days about torture. What's missing from this discussion is the purely practical: Torture doesn't work. Everyone from former CIA officials to the head of the Judge Advocate General's office to professional "interrogators" and even conservative writers [will] tell you what any decent police detective already knows: When you torture people, they will tell you what you want to hear, whether or not it has anything to do with the truth. Now, if your purpose is to be hateful and vindictive against brown-skinned people in funny clothes who fly airplanes into buildings, then torture might be your thing. But don't fool yourself into thinking it produces information of any value.

I object to our use of terror not on ethical grounds but on practical ones -- the same reasons I object to the war in Iraq. Neither is making any headway in the larger war on terror.


President Bush has threatened to veto the military budget if it includes a provision against torture sponsored by Sen. John McCain, R-Ariz., and supported by 90 senators.

The military understands that if we use torture, our enemies will feel free to use it on any of our soldiers who might be captured.

The world understands that if we endorse torture, we can never again hold the moral high ground in discussions within the United Nations. The American people understand that the use of torture is against everything we stand for.

The ones who don't understand why we should not be torturing people are the president and his closest advisers.


President Bush's adamant statement, "We do not torture," eerily reminds me of an equally adamant quote from a past president: "I am not a crook."

RAYMOND A. TAYLOR Southeast Portland

Regarding the issue of torture and the CIA: You can choose to believe a senator who was a prisoner of war, enduring torture for seven years in service to his country, or a vice president who got seven deferments to avoid military service to his country. I choose the senator.


It seems that it is easy for President Bush, Vice President Cheney and others to authorize methods of questioning that they believe are firm but others see as torture. It is easy for them to see these methods as not being torturous because they have never experienced them.

I think that anyone who wants to authorize or participate in such methods should be required to personally undergo such methods for a period of time. This would give them a much more informed basis for their authorization or participation.

LINDA J. ZENICANIN Southeast Portland

Iraq policy is dishonest

Our policies in Iraq have created more terrorists rather than fewer. We are unable to capture [all of] the leaders of al-Qaida in Iraq and elsewhere. We have lost more than 2,000 American service members and spent billions of dollars, yet we are no closer to capturing Osama bin Laden than we were on Sept. 12, 2001.

The violence continues unabated. What have we accomplished by being in Iraq for the last three years? The administration is unable to give an honest answer to that question.

President Bush continues to hold on to his misguided policy of staying the course until complete victory. It did not work in Vietnam, and it will not work in Iraq.


Vietnam vet backs Bush

Back when I was a young man, I remember many a wall was adorned with a picture of [Dwight D. Eisenhower] or Jack Kennedy. You didn't have to be patriotic to show respect. Party affiliation didn't obscure the honor of the presidency.

Today's treatment of President Bush is appalling. Here is a man who could be kicking back enjoying his millions. Instead, he's under the most concentrated and vile scrutiny any leader has ever endured. It makes me cringe when I see a man who is sacrificing so much be the source of so much ridicule.

This really hits home because I spent 365 days in Vietnam fighting a war under a president who makes Bush look like Abraham Lincoln.

That war also had little bearing on the future of our country, whereas the current conflict has huge implications. It's cool, especially in the Northwest, to be anti-Bush right now. I'm just not cool.

MIKE DAVIS Brush Prairie, Wash.

'My taxes are causing harm'

The Republicans have finally made me an anti-tax advocate.

Now that they're making budget cuts in all of the social programs that actually help people, appointing department heads who come from industries the agencies are supposed to regulate, and spending vast amounts of money on corporate subsidies, pre-emptive wars and secret prisons, my taxes are causing more harm than good.

Count me in on supporting tax cuts, especially if they go to the 90 percent of us who didn't benefit as much from the last ones.

BILL KOWNACKI North Portland

Quranic intelligent design?

I wonder if proponents for teaching intelligent design would be so fervent if the idea had originated in the Quran. GORDON MERSETH Southeast Portland

Futures of Wirth vs. Libby

State Rep. Kelley Wirth, D-Corvallis, has certainly been in the news a lot lately, for allegedly having an affair, being cited for drug possession, resigning from her seat [effective Nov. 15], and now pumping up payments to her mother as a legislative assistant.

What a difference between Wirth's mug shot and I. Lewis "Scooter" Libby's debonair image smiling manfully on his crutches from The Oregonian's front page. What a difference in their future prospects.

Wirth has both legs smashed and is permanently disabled. Libby's broken foot will probably recover.

Wirth may face jail and emerge to months of physical therapy and medical debts. Libby will probably get a pardon.

Wirth padded her mother's last month of salary. Libby's rich friends are filling his legal defense fund and will take care of him in style.

Both are innocent until proved guilty.


Medicare Part D is a mess

I am also a great-grandmother and I agree with Bea Kohnle (Letters, Nov. 5) that the only benefit Medicare Part D provides is to low-income seniors, but I think also to the insurance companies. She suggests the rest of us take a deep breath, choose a plan and pray it's right. I'm taking a deep breath and opting out.

This plan is a mess -- purposefully complicated and provides little help to most of us. If we pay the monthly premium, the deductible and then the co-pay for both my husband and me, the cost is well more than what we now pay for our medicines.

The threat that if we don't join now because it might cost more later is pure extortion and typical of the fear-spreading doctrine of this administration.

I'm hoping that we'll have a new president and Congress in a short time, and this mess can be corrected, perhaps with universal health care so that we'll all pay less.

DONNELLA SLAYTON Northeast Portland

Which penalty is more just?

Am I the only one perplexed that Christopher and Tammy Nickel got three years in prison for torturing and nearly killing their [young adopted] daughter, while Sung Koo Kim will serve more than four years for having a panty fetish ("Man apologizes for panty thefts," Nov. 8)?

I'll admit, a 3,000-panty collection is a bit freaky, but he didn't commit attempted murder. Did I miss something?


When police don't help

My heart goes out to Virginia Joy, whose son's custom-made BMX bike was stolen [during a burglary of their home]. The family saw it later in the neighborhood, but police refused to act (Letters, Nov. 7).

My house also was broken into twice. The first time I called the police, and although I knew exactly who did it and even had a witness, police refused to act. The second time it happened, I confronted the individual responsible and got my stuff back. Now that's what I call community-based policing.

Maybe the next time the family sees the bike, they should push off the kid who's riding it and reclaim their property. What's he going to do -- call the cops? Short of that, take his picture [while he is] on the bicycle and plaster it all over the neighborhood with the word "thief" pointing to him. Mail a copy to the police; maybe officers will add it to the report.

If the bike belonged to the mayor or the police chief's son, I wonder if police would respond differently.

KEITH LINCOLN Southeast Portland

Entitled to a privilege?

Is access to the Portland Art Museum a right or a privilege? Should we have the same rights of access as we do to the Portland Park Blocks or the Eastbank Esplanade?

Reading Susan Nielsen's column, "Portland art lovers glower at museum's too-tall gates" (Nov. 6), it's easy to see that some people believe access to art is a right.

If through our government we choose to make something a right, then a right it is. If we spend our tax dollars building a beautiful waterfront, then access to that is a right.

But in the world of not-for-profits, such as the Portland Art Museum, which rely on the generous gifts of donors and the fees patrons pay, access is by no means a right.

Running a museum is expensive business, and Portland Art Museum has risen to world-class caliber through its most recent ambitious expansion. Access to world-class works here in Portland is a privilege.


Insecure liberals

Good heavenly gracious. The letters page is beginning to read like Daily Kos. Six letters (Nov. 6) to tell us how much smarter liberals are than conservatives? Is the left really that insecure?

Well, yes. Liberals have to assert intellectual superiority; it saves them the embarrassment of actually having to debate. Anointed by their own preening -- "I think it, therefore it is" -- any view to the contrary is considered anti-intellectual. It's much easier to say "you're stupid" than to attend to facts.

Oh, well. The bad news is that the left owns academia, where [professors such as] Ward Churchill are considered mainstream, and conservative thought is considered unfit to hear. A little like The Oregonian letters page.


Going to the dogs indeed

In "Our lives are going to the dogs and we love it" (Nov. 6), it was reported that a customer purchased $600 worth of clothing for her dog during a single visit to a dog boutique in Portland's tony Pearl District.

This year, many of the less fortunate have lost loved ones, homes and all of their worldly possessions as the result of a chain of crippling natural disasters. Many individuals, with no need for public recognition, are contributing to efforts to rebuild lives and infrastructure in the affected areas.

In the face of the current state of the world, one wonders why The Oregonian chose to publicize the peculiar spending habits of a self-indulgent segment of our local populace. Perhaps the naysayers are correct when they say society is "going to the dogs."

SHARON L. CARVER Southwest Portland

Dead trees nurture new ones

I take exception to your editorial suggesting the Reps. Greg Walden and Brian Baird salvage plan is a smart idea ("Now the fight is over dead trees," Nov. 4). On the face of it, your argument seems to make sense, but you missed [part] of the science behind the debate: Dead trees are the critical component of restoring burned forests. It is the dead and decaying wood material that gives future plants and trees the nutrients they need to grow; they literally create new dirt.

The two years after a fire are the most critical for the life of a forest; it must be nurtured (not stripped) at that time for the reforestation to take hold.

There is a sensible and sustainable plan for forests: Don't clear-cut.

FRANK DUFAY Southeast Portland

Fingerprint those who pawn

There seems to be a fairly simple solution to the problem of pawnshops and metal purchasers accepting stolen goods. An ordinance could require a person who pawns or sells these items to leave a fingerprint on the information card. This would discourage thieves and give the police [evidence].

If the person accepting such goods does not require adequate proof of ownership, then it would be up to him to recover the money he is out -- not the real owner.

If a liquor store owner sells liquor to an underage person or a store accepts an illegal check, who is responsible? It should be the same with pawnshops.


2005 The Oregonian

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