FINDINGS

Primary Care Headed For Ruin, Doctors Say

Primary care -- the basic medical care that people get when they visit their doctors for routine physicals and minor problems -- could fall apart in the United States without immediate changes, the American College of Physicians said yesterday.

"Primary care is on the verge of collapse," said the organization, a professional group that certifies internists, in a statement. "Very few young physicians are going into primary care and those already in practice are under such stress that they are looking for an exit strategy."

Falling incomes, difficulties in juggling patients, soaring bills, and policies from insurers that encourage rushed office visits all mean that more primary-care doctors are retiring than are graduating from medical school, the organization said in its report.

The group has proposed a solution, calling on federal policymakers to approve new ways of paying doctors that would put primary-care doctors in charge of organizing a patient's care, and giving patients more responsibility for monitoring their own health and scheduling regular visits.

The proposal calls for innovations such as using e-mail to consult on minor and routine matters, rather than using expensive office-visit time. Doctors would be compensated for an e-mail consultation.

Teflon Chemical Called A 'Likely' Carcinogen

A chemical used in the manufacture of Teflon and other nonstick and stain-resistant products should be considered a "likely" carcinogen, according to an independent scientific review panel advising the Environmental Protection Agency.

The recommendation included in the panel's final draft report is consistent with its preliminary finding, which went beyond the EPA's own determination that there was only "suggestive evidence" from animal studies that perfluorooctanoic acid (PFOA) and its salts are potential human carcinogens.

Officials at DuPont Co., the top North American producer of PFOA, took issue with the panel's conclusions. "We disagree with the panel's recommendation on the cancer classification, and we continue to support the EPA's draft risk assessment," said Robert Rickard, director of health and environmental sciences for DuPont.

A majority of members on the review panel also recommended that the EPA's risk assessment include additional data on PFOA's potential to cause liver, testicular, pancreatic and breast cancers and its impact on hormones, the nervous and immune system.

Promising Tests For Ricin Vaccine

Initial tests indicate that an experimental vaccine for ricin works and is safe, raising the possibility that it might one day offer protection from the poison, which authorities fear could be a weapon for terrorists.

Ricin, a deadly poison extracted from castor beans, is easy to produce. It can be added to food or water, injected, or sprayed as an aerosol.

Researchers led by Ellen Vitetta of the University of Texas Southwestern Medical Center in Dallas found a way to modify the toxic sections of the ricin molecule to disrupt its poisonous effect.