When you combine politics and medicine as in this piece's title, you get on-the-Hill "position speak" which coins such terms as "patient safety" and creates the unspoken bind that any alternative position is "against patient safety." This is typical political Hill strategy but now it inserts itself into a health-care community not seasoned to this type of manipulation.
Now don't get me wrong, medical liability reform is needed. Certainly there are points made by senators Clinton and Obama that warrant careful consideration. But manipulation of physicians with such patient-centric titles (who doesn't want patient safety?) and legislation not yet "peer reviewed" in the halls of Congress (especially when no retort is published) in one of the most influencial and cited medical journals screams of bias and limits the objective credibility desired by its readers.
Does the publication of this work (which reiterates the legislation now moved to committee in the Senate and published previously) violate the Journal's own Ingelfinger rule? The NEJM boasts: "Just 8% of manuscripts submitted are accepted for publication and none are reported in any other medium prior to publication in NEJM." It now seems legislative opinion pieces are permitted a double standard - after all, this piece was presented before in the U.S. Senate on 28 Sept 2005 as Senate Bill 1784.
None of us are ignorant to the political overtones of this debate. Some have even suggested this legislation might consitute a bribe of physicians. Certainly more balanced opinions exist regarding this legislation and even more opinions exist on the validity of the data regarding medical liability and medical errors. But I ask: where are the senatorial perspective pieces in the Journal on the other medical liability reform legislation (like S. 22 or S. 23) recently fillibustered and defeated by Democratic interests on the Hill?
Or does this perspective piece fall under the guise of a Journal advertorial? If so, it was not properly labeled.
Perspectives are just that: perspectives. Certainly the influential nature of the authors of this piece bear notice. But their political position should not be permitted to manipulate the medical community in a medical journal until acceptably vetted on the floor of the Senate.