CME NOTES What's on the minds of young physicians? Younger docs in California are disappointed with their relationships with managed care organizations (MCOs) and their paychecks, according to a study of 884 physicians aged 35 to 40 appearing in the August 1998 issue of California Physician, a publication of the California Medical Association. The main source of dissatisfaction with MCOs was an ethical one. According to the study, conducted by Charlton Research, 52 percent of respondents said that denial of care was the biggest ethical issue they faced. Nearly three-quarters of respondents said they sometimes (57 percent) or frequently (16 percent) made patient care decisions based on financial issues.

Interestingly, most said they spent 90 percent of their time with patients, as opposed to handling administrative tasks, but they also said the amount of time per patient was shrinking.

And on the issue of pay, 58 percent said they were earning less than they had expected at this point in their careers.

The entire text of the study can be found at:

How are physicians in general doing financially? Not too badly, according to the AMA's 1997 Socioeconomic Monitoring System Survey. The average net income for doctors in 1996 was $166,000, a 3.75 percent increase from a $160,000 average net income in 1995. The U.S. Consumer Price Index rose 2.9 percent during the same period, as a comparison. Average income for physicians who are employees, according to the survey, was $142,000, while average net income for self-employed doctors was $198,000. The survey also showed that doctors worked an average of 56 hours per week.

Hot CME topic for 1998/ 1999: AIDS therapies. More therapeutic options are available than ever before, according to reports from the 12th World AIDS Conference, held June 28 to July 3 in Geneva, Switzerland. Eleven antiretroviral drugs are on the market, with four more expected to be approved shortly by the FDA. However, with standard regimens now incorporating three antiretrovirals, physicians and patients face a dizzying choice of more than 250 possible drug combinations. Problems reported at the meeting included widespread patient nonadherence, drug resistance, and complaints about complications caused by protease inhibitors.

Another hot topic: Y2K problems with medical devices. Y2K glitches could impact a variety of medical technologies, including defibrillators, X-rays, and infusion pumps, according to Kenneth Kizer, MD, undersecretary for health at the Dept. of Veterans Affairs. Hospitals also are subject to Y2K bugs in controlling climate, security, and elevators. Kizer spoke at a special Senate subcommittee meeting in August.

Osteopaths take a stand: In August, the 40,000-member American Osteopathic Association (AOA) approved a statement reflecting the osteopathic profession's stance on key health care issues, especially those relating to managed care.

To see the full text, visit the AOA Web site at