On Oct. 21, 2005, a small group of Riverside County Medical Association physicians and their significant others embarked on a short, but event-packed, 10-day trip to India. The two-fold purpose of the trip was to establish medical ties with Riverside's sister city Hyderabad and to be exposed to and better understand the complexities of modern-day India.

Three years ago I wrote an article for this magazine about whether healthcare was a right or just another necessary commodity, like food and shelter, to be purchased out of the family budget. It was my opinion that healthcare was perceived by 21st century Americans as a right and that no amount of economic or philosophical reasoning was going to change this feeling. Perception, in this case, was reality. Nothing in the past three years has caused me to change my opinion. If anything, it has been reinforced. Public attitudes have become even more fixed.

California is overdue for a new public medical school. The state's population is approaching 40 million, and the Inland Empire is where the growth and the need are greatest. The biomedical sciences program's strong foundation and UCR's diverse student body make Riverside the best location for a new medical school from social, scientific and financial perspectives.

The current controversy regarding the right to bill for noncontracted services rendered, also known as balance billing, pits two segments of the medical profession against one another. In one corner are large organized groups with capitation contracts whose compensation is adversely affected by out-of-plan patient care. In the other corner are physicians who render care on an urgent or emergent basis and who are not in the patient's network.

In a famous play by Goethe, a doctor is accused of practicing quackery. At his trial, he defends himself by stating that the practice of medicine is as much an art as it is a science.

It's sad what I hear in talking with physicians. They mostly express feelings of frustration and anger at the way insurance companies and health plans are second-guessing their recommendations and cutting their reimbursements. Further, their greatest unhappiness seems to stem from a feeling of loss about not being "the captain of the ship" with regard to patient care.

As an orthopedic surgeon and more-than-casual baseball fan, a June article in the American Journal of Orthopedics by Frank Jobe, MD, and Marilyn Pink, PhD, PT, titled "The Process of Progress in Medicine, Sports Medicine and Baseball Medicine," attracted my attention. Aside from detailing the specifics of orthopedic procedures, the article highlighted the increase in overuse injuries in our younger population. This ought to be of interest to physicians in general, especially primary care doctors and pediatricians, who often see these injuries initially.

Recently, Treasury Secretary Henry M. Paulson Jr. in a Wall Street Journal editorial said that better self-policing by physicians of their "errant" colleagues would reduce malpractice litigation and help control medical costs.