Diversity Article Spurs Readers to Respond

Local Medical School Working on Adding Diverse Doctors
As a first-year medical student just beginning to understand the bigger picture surrounding a lack of culturally competent care for California's diverse patient population, I was excited to see the attention given to the need for "boosting minorities in medical school" in the March cover story, "Diversity Dilemma." I wanted to point out that one Southern California medical school has just that at the core of its mission.

Charles R. Drew University of Medicine and Science, in partnership with the David Geffen School of Medicine at UCLA, admits 24 students each year, all of whom share a desire to provide culturally competent primary care to underserved urban populations. Traditionally diverse in both ethnicity and culture, these populations and their unique needs attract students from all backgrounds, particularly Latino and African-American.

Drew's continuing initiatives to recruit a diverse student body are clearly in line with statewide goals, graduating approximately 24 new MDs to serve those Californians most in need of healthcare.

Scott Nass
Medical Student
Drew/UCLA Joint Medical Education Program
Los Angeles

Foreign Medical Grads Struggle to Integrate in U.S. System

I am the editor of The Portland Physician Scribe, the magazine of the Medical Society of Metropolitan Portland. I read your March "Diversity Dilemma" article with great interest. Being married to a third-year resident who went to medical school in India, I am drawn to any topic that touches on the issue of foreign medical graduates, as did one of your sidebars for the article.

I have to say, however, I was slightly disappointed at the treatment your sidebar gave this topic. Based on what you wrote, it sounds so easy for foreign medical graduates to become part of the American medical fraternity. I only wish it were so. Foreign medical grads must struggle and fight twice as hard as their U.S. peers to become recognized and validated in this noble profession.

The main point of your sidebar was correct: Foreign medical graduates are a great way to add diversity to the medical workforce. Unfortunately, the reigning ruling bodies seem to want to make it as difficult and rigorous as possible for these graduates to do so.

I appreciate the mention of foreign medical graduates as a positive way to increase diversity in this country. I hope we get to see this become a reality in the near future.

Ekta R. Garg
Editor
Portland, Ore.


Medical World Article Missing Explanation of Malpractice Options

The Medical World article in the March issue dealing with medical malpractice coverage concerns was informative and interesting. Although the article's contributors encouraged a long list of valid questions by physicians to prospective malpractice carriers, they omitted explaining the various approaches to physicians' professional liability protection.

I am a physician participant in the Cooperative of American Physicians Inc./Mutual Protection Trust (CAP-MPT), which is a cooperative corporation and interindemnity structure. Rather than transferring risk to an insurance company, the 8,900 member physicians of CAP-MPT share risk with one another.

Traditional insurance companies charge premiums in amounts they hope will be sufficient to pay anticipated costs well into the future. Their premiums are based on assumptions about future investment earnings and the cost of malpractice claims among their insureds. CAP-MPT's approach to pricing relies on actual costs. Members pay assessments based on estimated claims payments along with defense and administrative costs for the upcoming year. This method of tracking costs over a shorter time allows CAP-MPT to provide coverage for approximately 20 percent less than traditional insurance.

For that savings, members do relinquish a bit of flexibility. Assessments by the carrier--that each member must pay--are usually made in November, thereby limiting the feasibility of changing carriers to a yearend timeframe.

Further, CAP-MPT will defend a claim only as long as a physician remains a member, unless he is retired or has purchased tail coverage.

Finally, a useful tactic in selecting a suitable liability carrier not mentioned in the article is communicating with fellow physicians in the same specialty regarding their interactions and their satisfaction levels with their respective companies. These physician colleagues will usually provide the most credible information about malpractice carriers.

Vincent Gualtieri, MD
Urology
Sherman Oaks