The American Society of Law, Medicine & Ethics (ASLME) and
Seton Hall University School of Law will co-sponsor the Third Annual Student Health Law Conference on Friday, October 16, 2009 in Newark, New Jersey, from 8:30AM to 5:00PM.
This conference, which is attended by law students from law schools throughout the country, seeks to expose law students to the myriad career paths for attorneys in health and life sciences. The conference provides an introductory session on health law, panels on a variety of employment opportunities in health law, and a networking reception with the conference speakers. Career paths that will be represented include academia, compliance, private firms, government agencies, nonprofit organizations, drug and device companies, health insurers, and hospitals. Speakers for this year’s conference have been chosen for their health law expertise and background.
The format of the conference is a series of panels focused around a particular kind of health law career. Each panel is approximately one hour long and comprised of two to four panelists. Students will have the opportunity to explore nontraditional employment opportunities across the health law spectrum, receive support and guidance from professionals familiar with the experience needed for various careers as well as recruitment and hiring processes, and network with health law attorneys.
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Neelu Pal, MD/Seton Hall Law Student
SURGEON/ONE L
Where Law & Medicine Meet
Today at Health Reform Watch we are truly pleased to introduce and welcome Neelu Pal, MD. She is both a board certified surgeon and a first year law student (”One L”) here at Seton Hall Law. Dr. Pal will be writing a regular column for us as she traverses the rigors of her first year in law school. The first year is hard– and transformative in a way that is actually rather hard to express: one simply does not think the same after the experience. Many have ably chronicled the process– Scott Turow’s One L is a classic; Paper Chase (yes I am that old) a personal favorite.
Turow:
In baseball it’s the rookie year. In the navy it is boot camp. In many walks of life there is a similar time in trial and initiation, a period when newcomers are forced to be the victims of their own ineptness and when they must somehow master the basic skills of the profession in order to survive. For someone who wants to be a lawyer, that proving time is the first year of law school.
Professor James R. Elkins,College of Law, West Virginia University on Turow’s One L and the first year of law school:
If legal education is an authentic rite of passage it may reflect an underlying archetypal transformation.
But perhaps most interesting– and not so well chronicled– is that Neelu Pal comes to this experience as a full fledged surgeon– schooled entirely in another method of thought. It is this meeting of the minds; this melding of law & medicine that we find fascinating– and truly look forward to publishing over the course of this next year. We here at Health Reform Watch and Seton Hall Law invite you to visit– Where Law & Medicine Meet.
About Dr. Pal
Neelu Pal is a board certified general surgeon who completed residency training in 2005 at University of Medicine and Dentistry in Newark. She went on to complete fellowship training in Bariatric surgery at University Medical Center at Princeton in 2007. She is currently self employed and in the process of starting a private practice in Jersey City. She believes that the law and medicine are based on similar profound ethical principles and is interested in this confluence and the impact that it has on health care delivery. She is especially interested in the areas of patient safety, fraud and abuse and drug and device law. Read
Curriculum Vitae
Self Employed as a Consultant for FairCode Associates, MD and Advanced Medical Reviews, CA
Fellowship in Bariatric Surgery – University Medical Center at Princeton, Princeton NJ
General Surgery Residency - University of Medicine and Dentistry (UMDNJ), Newark, NJ
Internship - University of Kansas Medical Center, Kansas City, Kansas
Postgraduate Training - Department of Surgery Armed Forces Medical College Pune, India
Medical Education - Bangalore Medical College, Bangalore, India
Board Certification by the American Board of Surgery
Medical Licenses
New York State License - Unrestricted, Current Certificate
New Jersey State License - Unrestricted, Current Certificate
Pennsylvania State License - Unrestricted, Current Certificate
Memberships
American Medical Association (AMA)
American College of Surgeons (ACS)
Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)
American Women Surgeons (AWS)
Selected Research Experience
- Research in the cellular effects of ischemia-reperfusion, University of Chicago, Department of Vascular surgery, 1999
- Clinical study to compare the outcome of below-knee amputation in ischemic limbs performed by the Burgess (long posterior flap) and skew flap techniques, Armed Forces Medical College, 1997
- Clinical study to determine the outcome of intra-arterial urokinase therapy for the management of limb ischemia due to thrombophlebittis obliterans, Armed Forces Medical College, 1996
- Clinical study on the use of omental flap for revascularization of ischemic lower limbs, Armed Forces Medical College, 1995
Selected Publications and Presentations
- “Sigmoid and Cecal Volvulus” Book Chapter, eMedicine, Feb 2008.
- “Intestinal fistulas: surgical perspective” Book Chapter, eMedicine, Feb 2008.
- “Radiation Enteritis and Proctitis” Book Chapter, eMedicine, Feb 2008.
- “Effect of limb length in Roux-en-Y Gastric Bypass in patients with BMI 45-50 kg/m2″ Poster, ASBS Annual Meeting, San Diego, CA, June 2007.
- “Bilopancreatic limb obstruction after Roux-en-Y Gastric Bypass” Poster, ASBS Annual Meeting, San Diego, CA, June 2007.
- “The Malpractice Insurance Crisis in Medicine” Grand Rounds, Department of Surgery, UMDNJ, Newark, NJ, April 2005.
- “Appendicitis and Pregnancy” Grand Rounds, Departments of Surgery and Obstetrics and Gynecology. University of Kansas Medical Center, Kansas City, KS, May 2001.
- “Below knee amputation - study with special reference to skew flap and long-posterior flap techniques,” M.S. Dissertation, Armed Forces Medical College, Pune (India), March 1998.
- “A case of carcinoid tumor of the kidney,“ Presentation at the Armed Forces Medical College Symposium, Armed Forces Medical College, Pune (India), October 1997.
- “A case of traumatic diaphragmatic hernia - unusual mode of injury,” Presentation at Command Hospital, Pune Surgical Society meeting, Pune (India), March 1997.
Neelu Pal, MD/Seton Hall Law Student
SURGEON/ONE L
Where Law & Medicine Meet
How did I get here? A Journey to the Center of Law and Medicine.
Seton Hall University School of Law
I am at the threshold of a great space filled with light and knowledge. I am surrounded by brilliance and awed by the precision of thought and word that emanates from the people around me. It is a space that is flooded by light from the very sky above. This is my first day as a student of the law: a surreal experience for most 1Ls, even more so for me as a surgeon. How did I get here, to this crossroads of the law and medicine?
Unlike many other students of the law, I did not grow up with aspirations of becoming a lawyer; I grew up dreaming of becoming a surgeon. I have always loved surgical history, and as a child one of my favorite books was an old edition of a textbook of surgery called 
Bailey & Love. I found it in my grandparents’ library in my ancestral village home in North India. I spent endless summer afternoons reading with fascination the little footnotes and anecdotes about surgical history. I developed an unwavering determination to be a surgeon. And I achieved that– after spending over twelve years in intensive medical education and rigorous surgical training.
My experiences during medical school taught me that the ethical obligation towards the patient was the physicians’ paramount duty. I saw indigent patients who placed absolute trust in their physicians, and physicians who rendered their duty with a genuine desire to help patients. In contrast, residency training and fellowship training brought me to the realization that ethical obligations towards patients were governed by law, and not just dispensed from the goodness of the hearts of physicians. A spectrum of clinical experiences over the years leads me to appreciate that the impact of the law on the practice of medicine is both constant and profound. Now, more than ever while the debate over health care reform ebbs and surges, the laws that govern medicine come sharply into focus. The end of this debate is not in sight, and the turbulence is likely to continue well into the future. Legal scholars are uniquely poised to provide their insight and direction to this process. This is what brings me here — to learn a new way of thinking, and then to bring this thought process to the field I love — surgery.
As a 1L I am impressed at how unique the legal thought process is: the aim is to transcend individuality while preserving it to the maximum extent possible within the context of society! My medical training emphasized linear and single dimensional thinking. I now have to learn how to think in a four dimensional space to validate descriptions of concepts that are constantly morphing and moving; to make compelling arguments for positions that I may not agree with, yet need to know. And yet it strikes me: What an amazing time to be in this field– to learn and grow within the practice of law and medicine while the debate over healthcare and how to achieve reform rages on.
Read More About Dr. Neelu Pal Here.
Senator Ted Kennedy testifying before the House Judiciary Committee, beside Peter Rodino, Chairman.
Senator Ted Kennedy with Congressman Peter Rodino, before the Judiciary Committee– of which Rodino was Chair.
Peter Rodino served as a member of the House of Representatives from 1949 to 1989–at which time he retired to a Professorship at Seton Hall Law until his death in 2005.
Senator Kennedy worked often with Peter Rodino. In her book “Fifty-Two Words My Husband Taught Me,” Joy Rodino recounts that “Upon Peter’s passing , Ted Kennedy said that during the Watergate inquiry, ‘Many of us felt that we were seeing a Founding Father in action, living the highest ideals of the Constitution. I’m sure my brother would have called him a profile in courage. I feel the same way.’”
Peter Rodino, Ted Kennedy (1978)
The Fifty-Two words that Peter Rodino so lovingly referred to so often are those of the Preamble to the Constitution. The guiding light of Peter Rodino’s career– and of our country–those Fifty-Two words are The Who, The What and The Why of the Great Document.
Included within the Preamble as reasons for creating this more perfect Union and its Constitution are “to… promote the general Welfare, and secure the blessings of Liberty to ourselves and our Posterity.”
As that is The Why, Ted Kennedy functioned as The How of that great clause in a long and fabled career in the Senate. He gave the last full measure of his life to that cause; the Flag at Seton Hall Law flies at half-mast in his honor.
Today we are very pleased to welcome Tracy E. Miller, J.D., to Health Reform Watch. Ms. Miller is the Executive Director of Seton Hall Law’s Center for Health & Pharmaceutical Law & Policy. She received her J.D. from Harvard Law School, cum laude, and her undergraduate degree from Brown University, magna cum laude. From 2001-2007, Ms. Miller served as General Counsel and Senior Vice President of the Catholic Health Care System (CHCS), a health care system comprised of hospitals and nursing homes in New York City and the Hudson Valley. While at CHCS, Ms. Miller oversaw legal and compliance services for the Health System and its ten member facilities. Prior to joining CHCS, Ms. Miller was Vice President for Quality and Regulatory Affairs at the Greater New York Hospital Association.
From 1996-2000, Ms. Miller was Associate Professor in the Department of Health Policy at the Mount Sinai School of Medicine, where her scholarship and publications focused on a range of topics, including medicine online, financial disclosure, and trust in the patient-physician relationship, and managed care regulation. During that time, Ms. Miller also served as Project Director of the National Quality Forum Planning Committee, a group of national leaders in health care delivery and quality convened by Vice President Gore. The committee was charged with building a new national organization to set standards for quality measurement and improvement across the health care industry. Prior to joining Mount Sinai, Ms. Miller was the founding Executive Director of the Governor’s Task Force on Life and the Law, a commission of experts and leaders drawn from healthcare, legal, civic, and religious organizations to craft policy for New York State. In that capacity, she developed law and policy on issues raised by medical advances, including New York’s health care proxy law, the do-not-resuscitate law, and the law on the procurement and distribution of organs for transplantation.
Ms. Miller is the Past Chairperson of the 1100-member Health Law Section of the New York State Bar Association and a Member of the Health Law Section Executive Committee from 1995-2001. She has written and spoken extensively to national and state organizations on healthcare policy, law and ethics. She joined Seton Hall Law School’s Center for Health & Pharmaceutical Law & Policy as Executive Director in 2008.
Today we are very pleased to welcome Kathleen M. Boozang to Health Reform Watch. Seton Hall University School of Law Associate Dean and Professor of Law, Kathleen M. Boozang has dedicated much of her career to nonprofit governance issues, with a special focus on religiously-sponsored hospitals. In the last several years, however, she has expanded her research and teaching to explore the legal and policy issues related to the global pharmaceutical and medtech industries, many of which make New Jersey their headquarters. Dean Boozang oversees the Gibbons Institute of Law, Science and Technology, and the Center for Health & Pharmaceutical Law & Policy.
In addition to her duties at the Law School, Dean Boozang serves on the Board of Directors of the American Health Lawyers Association. This year she was named a Fellow to The Hastings Center, an independent nonprofit bioethics research institute. Also this year, Dean Boozang was elected as a Fellow to the American Bar Foundation , an honorary organization of legal practitioners. She serves on the Editorial Board of the Journal of Health and Life Sciences Law and is a past editor-in-chief of the Journal of Law, Medicine & Ethics. She is past president of the American Society of Law, Medicine & Ethics and also previously sat on the Advisory Board of the Journal of Health Law.
Throughout her legal career, Dean Boozang has been active in public service. She has served on numerous advisory boards and committees for healthcare providers and for the states of New Jersey and New York, including serving as an advisor to the Attorney General Task Force on Physician Compensation by Pharmaceutical Companies, which sought to determine if and how patient care in New Jersey is impacted by the practice of pharmaceutical companies giving gifts and other compensation to physicians. She is currently a member of the New York State Task Force on Life and the Law, an interdisciplinary commission with a mandate to develop public policy on bioethical issues.
Dean Boozang graduated from Washington University School of Law in St. Louis, Mo., where she was inducted into the Order of the Coif and served as the managing editor of Law Quarterly. She received her LL.M. from Yale Law School in 1990.
She was named the Seton Hall University Woman of the Year Award in 2006 and was named Washington University Law School’s Young Alum of the Year in 2004.
Seton Hall University School of Law’s Center for Health & Pharmaceutical Law & Policy has called for broad reforms in the marketing of drugs and devices. In a whitepaper, entitled, “Drug and Device Promotion: Charting a Course for Policy Reform,” the Center proposes legal and policy changes to address conflicts of interest in the relationship of medicine and industry. “The time is right for reform in the marketing of drugs and devices to doctors,” said Center Executive Director Tracy Miller. “Conflicts of interest have become pervasive in medical practice. Reform is needed to ensure that patients’ interests are at the heart of medical education, practice, and research,” she said.
The Center recommends: (1) making payments by drug and device companies to doctors transparent, with public disclosure by industry and physicians of their financial relationships; (2) adopting federal legislation to ban gifts, meals and other benefits provided to doctors as part of the current marketing model; (3) setting new policies to give FDA the authority to require studies of safety and efficacy of drugs and devices used off-label; and (4) undertaking a fundamental change in funding for continuing medical education to end industry support.
Moving to Transparency. The Center recommends that payments by drug and device companies to doctors should be publicly disclosed. “Transparency is critical to shore up public trust in physicians and the collaboration of industry and medicine,” said Tracy Miller. Transparency would also foster better practices by doctors and industry, advance government oversight, and provide information to the press and public. Pending federal legislation, the Physician Payments Sunshine Act, would require industry to disclose payments to doctors.
The Center supports this approach. It also recommends that states undertake disclosure by doctors, and decide how information about physician financial relationships with industry could best be shared with patients. Law Professor Kathleen Boozang adds that, “If doctors had to disclose payments from industry it would prompt them to examine their practices through the eyes of their patients and peers.”
Banning Gifts, Meals, Perks. The Center proposes adoption of federal legislation to ban the use of gifts, meals, and other perks to promote drugs and devices. The states have taken the lead to date–Massachusetts, California, Minnesota, and the District of Columbia have passed laws to limit or ban gifts and meals that are now routine in marketing practices. Concluding that industry self-regulation is not sufficient, the Center calls for national legislation to create uniform practices by industry and physicians. As urged by Professor Boozang, “the benefits of drugs and devices should drive promotion and physicians’ decision to prescribe, not a marketing model that depends on gifts and meals.”
Promoting Scientific Study of Off-Label Uses. The Center proposes that national policy should be redesigned to assure that physicians, patients and government have reliable information to make informed choices about off-label medications. Estimates suggest that as many as 40% of all prescriptions are for off-label uses. The FDA has recently issued guidelines to promote integrity and accuracy in medical articles that drug and device companies give to doctors. The Center urges that this policy guidance, while useful, does not go far enough to provide crucial information about the safety and efficacy of drugs and devices prescribed by doctors for uses other than those approved by the FDA.
The Center proposes giving FDA the authority to mandate scientific studies for off-label medications and devices that have high sales volumes or large profits but lack needed evidence of efficacy or safety. This would protect the interests of patients and advance sound choices about the risks, benefits, and economic value of off-label uses.
Reforming Funding for Continuing Medical Education (CME). Most states require physicians to undertake continuing medical education to maintain their medical license. The drug and device industry currently funds over half of the accredited CME courses available to physicians. The Center recommends that industry funding for continuing medical education should be phased out, and replaced by an educational process driven by physicians. As stated by Tracy Miller, “Physicians need to retake control of their professional education. CME should focus on doctors as professionals caring for the whole patient, not just as prescribers of drugs and devices.” While the transition to new funding occurs, the Center recommends that speakers at CME events should disclose more information about their financial interests, and physicians who are paid to promote drugs and devices should not speak at CME events about those products.
Factual Background for the Recommendations
- Ninety-four percent of physicians have some kind of financial relationship with industry, as reported in a major recent national study.
- Five states–Maine, Massachusetts, Minnesota, Vermont and West Virginia– have required industry to disclose financial relationships with physicians.
- As shown by a recent Congressional investigation of payments by industry to prominent psychiatrists, even at universities with strong disclosure policies, practices have not kept pace, leaving the public in the dark about financial ties between physicians and industry.
- Medications are widely used off-label, especially in certain fields such as psychiatry, pediatrics, and oncology. A recent study found that 73% of off-label uses lack evidence of efficacy.
- Commercial support for accredited CME, nearly all of it from drug and device manufacturers, grew from $302 million in 1998 to $1.2 billion in 2006.
Read Whitepaper here.
Tags: Ban Gifts, Center White Papers Position Papers Conferences & Presentations, CME, Continuing Medical Education, Drug and Device, Drug and Device Promotion: Charting a Course for Policy Reform, FDA, Off-Label Promotion, Seton Hall Law, Seton Hall University School of Law, Think Tanks, Transparency
Seton Hall University School of Law mourns the passing of one of its most beloved professors, William E. Garland. Dean Patrick E. Hobbs said, “Professor Garland was a phenomenal teacher of future attorneys. He knew the law, but more important, he knew how to inculcate professionalism and an ethical sense in his students. He was also extraordinarily patient, demanding from his students the precision necessary to be a good lawyer. His loss affects the entire legal and academic communities, as he was also very involved in law reform efforts, as well as public service. Even with his vast accomplishments, Bill was nothing less than a great man whose company you always enjoyed.”
Born in 1944, Professor Garland earned his Juris Doctor from Seton Hall University in 1969. He joined Seton Hall Law as an adjunct professor in 1970 and became a full professor in 1976. He served as associate dean from 1983 to 1984. Prior to joining Seton Hall Law, Professor Garland was a partner in Stanziale and Garland, a law firm in Newark. He served as the long-time representative of Seton Hall University to the New Jersey Law Revision Commission. The American Bar Association’s Central and Eastern European Law Institute called upon Professor Garland’s expertise in property law and commissioned him to prepare a commentary for Romanian legislators regarding that country’s expropriation law. He was a member of Academics for the Second Amendment and the Foundation for Individual Rights in Education.
Over the years, Professor Garland taught many classes, but was most noted for teaching property and bankruptcy courses. He was also instrumental in the formation and multi-decade success of Seton Hall Law’s Legal Education Opportunity (LEO) program, tailored to provide gifted law school aspirants from economically and educationally challenged backgrounds with the opportunity to demonstrate their ability to succeed in the study of law. Professor Garland often referred to his participation in the LEO program as one of the highlights of his legal career.
The qualities of Professor Garland were best expressed by his former law school classmate and colleague, Dean-Emeritus Ronald Riccio, who said, “Bill Garland loved Seton Hall Law and had a heart of gold. No one was better at attention to detail. He was a superb lawyer, teacher, and good friend. He loved coming to work. His enthusiasm for the law, debate, and genuine affection for people, will be missed deeply.”
Professor Garland is survived by his sister, Sister Barbara Garland, SC, Councilor of the Sisters of Charity at the Convent of St. Elizabeth in Convent Station, NJ.
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