This Article explores the constitutional, statutory and common law privacy rights of physicians given the inescapable role of delivery data under supply side competition. The Article begins with a general review of the federal constitutional right of privacy. It then discusses the statutory protection given to physician-specific data under current federal law, and considers the insights gained from the controversy over physician data and the federal Freedom of Information Act. The remainder of the Article analyzes the usefulness of several common law causes of action to remedy the misuse of physician data, and concludes with recommendations which may obviate the need for litigation to protect against misuse of physician-specific data.

This Article offers a practical guide to hospital initiated quality assurance. After outlining the hospital's duty of care, the Article discusses both offensive and defensive strategies for dealing with the problem of an impaired or incompetent medical staff member. While the Article advocates informal resolution of the problem, it encourages the hospital and the medical staff to build a defense to liability based on strict adherence to hospital bylaws, rules and regulations governing medical staff organization, privileges and evaluation. The Article's ultimate concern is to avoid an escalated situation involving multiple lawsuits, patient harm, humiliation to the practitioner, and economic loss.

Increasing numbers of couples have benefitted from, or may be considering use of, the surrogate mother procedure. In this procedure, a couple, usually a husband and wife, enters into a contract with a surrogate mother. Under the terms of the contract, the surrogate mother is artificially inseminated, bears a child, and relinquishes all rights regarding that child to the semen donor and his wife. In exchange for bearing a child, the surrogate mother often receives a fee. In light of such increased use of the procedure, the issue of whether or not the arrangement is legal has particular importance. Questions of legality involve possible violations of criminal baby-selling statutes. Issues of whether adoption is necessary and whether the child is legitimate also are inherent in the surrogate mother arrangement. This Note argues that these questions should be resolved in favor of finding no impediment to the use of the surrogate mother procedure, at least within certain guidelines. However, even in the absence of legal impediment, detailed contracts and thorough medical screening for genetic, physical and psychological problems would further eliminate ambiguities regarding liability. In addition, the Note concludes that legislation should be enacted to deal with the legal ambiguities of the surrogate mother arrangement. This legislation should regulate the parties that enter into such an arrangement and the rights and responsibilities of these parties.

Ever increasing hospital costs burden both the patient and the state. Those patients fortunate enough to afford health insurance pay higher premiums for it, while the uninsured must absorb a substantial amount of the increase in hospital costs. The state also encounters greater expenditures in the Medicare and Medicaid budgets. To address the problem of increasing hospital costs, Massachusetts enacted a rate setting program in 1975 in which a rate setting commission reviews annual hospital budgets and determines prospectively what hospitals may charge the public for certain services.

In 1979, Massachusetts implemented a refinement of this procedure, known as groupings-based charge setting. By scrutinizing the reasonableness of underlying costs on which proposed charges were based, the groupings procedure sought to decrease the rate of increase of costs and charges while indirectly decreasing the rate of increase for Medicaid and Blue Cross reimbursement. Although the procedure should prove efficacious in future years, its initial development and use in Massachusetts encountered implementation problems.

This Note examines the initial groupings procedure in order to reveal the errors future programs should avoid in designing and implementing groupings. It explores why and how Massachusetts groupings were ineffective and traces the weaknesses in the administrative process. Additionally, the Note examines the need to improve the development and implementation of groupings rather than relying on post-implementation legal challenges to groupings regulations. Finally, this Note proposes a model for effective groupings that coordinates state-wide incentives for cost control, more accurately defines reasonable cost for purposes in addition to charge control, and seeks to avoid the mistakes of the initial Massachusetts groupings.