No More Butts

The dangers of smoking are well documented, buttalk to most physicians and they'll tell you thatgetting patients to quit is often a frustrating andthankless task. Statistics tend to confirm this view—according to various studies, anywhere from 50% to75% of smokers who quit eventually take up thehabit again. That's why a recent newsletter mailed toNew York City physicians from the city's HealthDepartment came as such a shock.

The newsletter, which was devoted entirely tonicotine addiction, warned doctors that failing toprovide "optimal counseling and treatment"to getsmokers to quit could be judged as failing to meetthe "standard of care,"and could leave doctors opento malpractice suits. Coincidentally, the newsletterappeared shortly after Mayor Michael Bloombergand the City Council agreed on one of the toughestsmoking bans in the country, outlawing smoking inbars, restaurants, and public places.

A spokesperson for the New York County MedicalSociety said the notice held doctors to an "impossiblestandard"that went far beyond a physician's obligationto urge patients who smoked to quit. Even theNew York State Trial Lawyers Association criticizedthe idea, with a spokesperson noting that allowinglawyers to set the standards of medical care was nota good policy. The Health Department defended thenewsletter, saying it was a tool to educate doctorsand to influence and improve medical practice. Thenotice serves to help doctors improve patient carewhile reducing their potential liability, according to aHealth Department spokesperson.