MedChi ousts a leader in lobbying dispute


A story in yesterday's editions of The Sun incorrectly identified the hospital affiliation of Dr. Donald H. Dembo, newly chosen president-elect of the Medical and Chirurgical Faculty of Maryland. Dr. Dembo is chief of cardiology at Good Samaritan Hospital and teaches at Sinai Hospital.

The Sun regrets the errors.

The state medical society, apparently unhappy with the way Maryland doctors were represented in Annapolis this year, has ousted one of its top leaders in protest.

Dr. Joseph Fastow, who has held the third highest post of the Medical and Chirurgical Faculty of Maryland, had been expected to become president-elect when the group met over the weekend in College Park.

Instead, in a rare contested election, the society's 193-member House of Delegates chose Dr. Donald H. Dembo, chief of cardiology at Sinai Hospital in Baltimore. As president-elect, Dr. Dembo will automatically become MedChi's president next May.

Dr. Fastow, an emergency room physician at Calvert Memorial Hospital, was involved in the society's controversial decision last November to replace legislative lobbyist Gerard E. Evans with former Gov. Marvin Mandel. The move prompted some prominent physicians, including Dr. Dembo, to resign their positions on MedChi committees in protest.

Dr. Dembo said yesterday that he had not sought the job of president-elect, but was "inundated" by calls from colleagues last Friday asking him to run. He said he thought Maryland physicians felt neither their interests nor those of their patients were properly represented during the General Assembly's discussion of a major health reform bill, known as House Bill 1359.

"There was a very strong feeling that the input of MedChi for 1359 was not adequate," Dr. Dembo said yesterday. "I think in large measure the vote was a protest vote."

Dr. Fastow conceded there was unhappiness with the selection of the 72-year-old former governor as the medical community's most visible representative in Annapolis, but he defended Mr. Mandel's performance as well as the medical society's support of the health reform legislation.

"I am very happy with his services. I think he did a very good job for us," Dr. Fastow said.

Mr. Mandel was out of town and could not be reached for comment. He has a one-year, $70,000 contract with the medical society.

The health care reform bill, which is designed to make health insurance available to employees of small businesses, also created a powerful new commission with the authority to monitor and regulate physician services and fees. The measure initially caught the medical society by surprise.

By the time MedChi officials got involved in the drafting of the legislation, the bill had gained such political momentum it was virtually unstoppable.

Dr. Fastow said there was nothing in the final product "so onerous that we could not support it." Besides, he said, "there would have been a substantial downside to the medical association for opposing it. We portrayed ourselves as wanting to be part of the solution rather than part of the problem."

He described the weekend election as "a settling of political scores, a readjustment of the politics of the organization."

He added: "This is a constructive state of affairs. If it is being portrayed as anything else, it is an error."

Dr. Dembo, however, said doctors generally believe they will be hurt by House Bill 1359, and at best are uncertain what the new seven-member Health Care Access and Cost Commission will do to them.

"The bill is so omnibus in its content that it is sort of a carte blanche to a commission of seven people to do whatever you please," Dr. Dembo said, complaining of a national frenzy to enact health care reform without necessarily thinking through the consequences.

"We know it needs amendments, substantial changes in this bill," he said.

When asked to be more specific, he replied: "It starts on Page 1 and ends on Page 87."

Dr. Dembo would not speculate on what his election will mean tMr. Mandel's future as the medical society's lobbyist.

"It hasn't been discussed. I don't even know what Marvin'contract looks like," Dr. Dembo said. "It may be Marvin is the best man for the job. But I recognize it is my responsibility to look at it."

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