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CHEESECAKE ON THE RIVERWALK Zbei kaiva roo court Serving sandwiches to seafood, from 11:30 until 11:30 every day of the week; open till midnight in the Metro Center, San Antonio, Texas 8 AUGUST 14, 1981 state’s 179 medically-underserved counties Any legislative interest in addressing the health care shortage .was diverted early in the regular session to the comparatively narrow issues of discrimination against osteopaths and authorization for optometrists’ use of diagnostic drugs \(TO both houses adopted a hands-off attitude toward those two disputes, which torpedoed the bill during the regular session. They preferred to accept whatever compromises the Texas Medical Associwith its regular session antagonists House Speaker Billy Clayton and his optometrist friends, and the Texas Osteopathic Medicine Association TMA and TOMA settled on nondiscrimination language within the first week of the special session. Their agreement will prohibit publiclysupported hospitals and institutions from basing staffing decisions on whether a physician’s medical degree is Doctor of propriate standards, such as speciality training, to insure that physicians are professionally qualified to do what they’re hired for. The optometry issue was not so easily resolved. At one point Clayton and the optometrists thought they had reached a compromise with the doctors, and both sides retired with their attorneys to polish up the final wording. When TMA returned hours later with a substantially different proposal than what Clayton had agreed to, negotiations came to an angry halt. But a subsequent ten-hour meeting finally produced a compromise. Optometrists will now be able to use diagnostic drugs if they have a written authorization, or “standing delegation order,” from a local physician. The agreement protects physicians from liability for an optometrist’s actions and allows the revoke the standing order of an optometrist whom it finds using the drugs improperly. Physicians thus retain technical control over optometrists’ use of the drugs, since a standing order is a physician’s mechanism for delegating medical authority to a non-physician. But in practice optometrists will be able to use the drugs without interference from the medical profession in most cases. A few legislators used the special session to revive criticisms of the act that had been shelved during the regular session. Responding to testimony from the Health Freedom Council, Rep. Bill Keese of Somerville tried unsuccessfully to amend the bill in House committee to give doctors disciplined by the board added legal protection during the appeal process and to narrow the definition of medical practice to protect alternative health-care providers from prosecution. Doggett .got the Senate to strengthen conflict-of-interest provisions covering board employees, but his amendment to prevent TMA board members from serving on the BME failed. Common Cause lobbyist Donna Mobley had pointed out to both House and Senate committees that six members of the TMA board sit on the BME. Common Cause lobbied in vain for the legislature to discourage this cozy relationship between the board and the profession it regulates. A Doggett amendment allowing patients who are wrongly denied access to their medical records to sue for damages passed the Senate, but was deleted by the House. The House also defeated Hinojosa’s attempt to require local medical societies to report to the board any formal disciplinary action taken against a doctor. Hinojosa argued that a local medical society’s most stringent sanctions could do nothing to prevent an incompetent doctor from practicing medicine: only the board can revoke a license. A physician censured by a local medical society can simply move to another city and continue to practice, he said. A majority of the House apparently bought the sponsor’s argument that local medical societies would be reluctant to discipline doctors if the action had to be reported to the board. They voted down the Hinojosa amendment 90 to 48. Interestingly, the pro-TMA argument on this point certainly contains the kernel of an implication that doctors are loath to report on each other, even when public safety is at stake. Aside from the optometry and osteopathy compromises, the TMA got what it wanted in the new Medical Practice Act: the continuation of a physician-dominated, self-regulating health care delivery system seldom bothered by interference from consumers, other health care providers or, indeed, the Texas legislature. SUSAN RALEIGH Quiche. Evening Romance. Continental Steaks. Mysterious Women. Famous Pastries. Cognac & Midnight Rendezvous. In short, it’s about everything a great European style restaurant is all about. as n Olcl Cafe St 310 East 6th St. ei . Austin, Texas \(-4;