An individual practice association (IPA) is a corporation or a partnership composed of physicians which contracts with health maintenance organizations (HMOs) to provide medical services to HMO subscribers. Since physicians typically practice independently, any agreement or arrangement among them may be perceived as an agreement of competitors. Hence, IPAs run the risk of challenge under the antitrust laws for activities such as price-fixing and the exclusion of physicians from membership.

Prior to the recent Supreme Court decision in Arizona v. Maricopa County Medical Society, it appeared that courts were willing to consider a variety of factors that distinguished antitrust cases concerning health care providers from antitrust cases in the commercial marketplace, and to find that conduct by providers did not constitute antitrust offenses. Indeed, an earlier article appearing in Law, Medicine & Health Care analyzed the lower court's decision in Maricopa and discussed the development of this trend.

The application of the antitrust laws to the health care field has generated intense debate over the last few years. Responsible for this debate in no small measure are the numerous health care antitrust cases that have reached and been decided by the United States Supreme Court. In the final weeks of the October 1981 term, the Court decided three such cases which should be of great interest to health care professionals. Although each involves a different point of law, collectively the decisions underscore the increasing amount of litigation that challenges joint conduct by health care providers, and the increasingly rigorous scrutiny that courts are giving such conduct under the antitrust laws.

The case that has received the most recent attention is Arizona v. Maricopa County Medical Society,’ which involved an alleged price-fixing agreement among physicians. Defendants were the county medical societies in Maricopa and Pima Counties in Arizona, and the foundations for medical care which each society had created.

Rare is the pharmacist today who does not participate as a service provider in one or several third party prescription insurance programs. Latest figures indicate that 372.7 million prescriptions or 25.4 percent of all prescriptions dispensed in this country were paid for at least in part by some form of prescription drug insurance.’ The economic impact which these third party programs are having on the retail pharmacist has caused their prominence as one of the most serious and important issues in pharmacy today.

Most third party prescription programs (TPPPs) are similar in structure and include a program administrator or insurance company, a sponsor (often an employer or labor union), subscribers or beneficiaries. and the participating pharmacies. Typically, the insurer or program administrator (hereinafter. the administrator) offers a contract or a “pharmacy agreement” to each pharmacy in a particular area. Each pharmacy must then decide whether or not to accept the agreement and become a participating pharmacy.

Consumer demand and federal support has caused the number of certified nurse-midwives to quadruple in the last decade, from 629 in 1970 to 2500 in 1982. Despite their record of reducing infant mortality and satisfying consumers, nurse-midwives are still an underutilized health resource. This article provides a brief history of nurse-midwifery. describes nurse-midwives’ education and current legal status, discusses obstacles to wider use of nurse-midwives, and examines the issues of safety and cost-effectiveness of nurse-midwifery practice.

The word “midwife” often evokes images of home births attended by “granny” or “lay” midwives who lack formal education in obstetrics. Yet, professionally educated nurse-midwives have practiced in this country since 1925, when an American nurse, educated in nurse-midwifery in England, came to the mountains of eastern Kentucky.

On July 1, 1982, the United States Supreme Court issued its opinion in Mississippi University for Women v. Hogan, ruling that the “female only” admission policy of a state-supported nursing school violated the equal protection clause of the fourteenth amendment. The case has political and legal implications not only for nursing education, but for the nursing profession as well.

Joe Hogan, a registered nurse, worked as a nursing supervisor in a medical center in Columbus, Mississippi. In 1979, he applied for admission to the baccalaureate program at Mississippi University for Women (MUW) School of Nursing, located in Columbus. Although he met all of the school’s substantive admission criteria, Hogan was denied admission solely because MUW has, since its inception, admitted only females. The school’s policies would, however, permit him to audit nursing courses and to attend continuing ed,ucation courses.