1
                                                                    EXHIBIT 3.44


                                     BY-LAWS
                                       OF
                                MED: ASSURE, INC.

                                    ARTICLE I
                             MEETING OF SHAREHOLDERS

         1. Annual Meeting. The annual meeting of the shareholders shall be held
at such time and place, either within or without this State, as may be
designated from time to time by the directors.

         2. Special Meetings. Special meetings of the shareholders may be called
by the president, a majority of the board of directors, or by the holders of not
less than ten percent (10%) of all the shares entitled to vote at such meeting.
The place of said meetings shall be designated by the directors.

         3. Notice of Shareholder Meetings. Written or printed notice stating
the place, day, and hour of meeting, and in the case of a special meeting, the
purpose or purposes for which the meeting is called and the person or persons
calling the meeting, shall be delivered either personally or by mail by or at
the direction of the president, secretary, officer, or person calling the
meeting to each shareholder entitled to vote at the meeting. If mailed, such
notice shall be delivered not less than ten (10) days nor more than two (2)
months before the date of the meeting, and shall be deemed to be delivered when
deposited in the United States mail postpaid and addressed to the shareholder at
his address as it appears on the stock transfer books of their corporation, and
shall be deemed delivered when actually received by the shareholder. The person
giving such notice shall certify that the notice required by this paragraph has
been given.

   2
         4. Quorum Requirements. A majority of the shares entitled to vote shall
constitute a quorum for the transactions of business. Once a share is
represented for any purpose at a meeting, it shall be deemed present for quorum
purposes for the remainder of the meeting and for any adjournment of that
meeting unless a new record dates is or must be set for that adjourned meeting.

         5. Voting and Proxies. If a quorum exists, action on a matter (other
than the election of Directors) shall be approved if the votes favoring the
action exceed the vote opposing the action. A shareholder may vote his or her
shares either in person or by written proxy, which proxy is effective when
received by the secretary or other person authorized to tabulate votes. No proxy
shall be valid after the expiration of eleven (11) months from the date of its
execution unless otherwise provided in the proxy.

                                   ARTICLE II

                               BOARD OF DIRECTORS

         1. Qualification and Election. Directors need not be shareholders or
residents of this State. They shall be elected by plurality of the votes cast at
the annual meetings of the shareholders at which a quorum is present. Each
director shall hold office until the expiration of the term for which he is
elected, and thereafter until his successor has been elected and qualified.

         2. Number. The number of directors shall be fixed from time to time by
the shareholders, or by a majority of the entire board of directors, but shall
never be less than the number required by the law.

         3. Meetings. The annual meeting of the board of directors shall be held
immediately after the adjournment of the annual meeting of the shareholders, at
which time the officers of the corporation shall be elected. The board may also
designate more frequent intervals for regular meetings. Special meetings may be
called at any time by the chairman of the board, president, or any two (2)
directors.


                                      -2-
   3

         4. Notice of Directors' Meetings. The annual and all regular board
meetings may be held without notice. Special meetings shall be held upon notice
sent by usual means of communication not less than three (3) days before the
meeting.

         5. Quorum and Vote. The presence of a majority of the directors shall
constitute a quorum for the transaction of business. Notice of an adjourned
meeting need not be given if the time and place to which the meeting is
adjourned are fixed at the meeting at which the adjournment is taken, and if the
period of adjournment does not exceed one (1) month in any one adjournment. The
vote of a majority of the directors present at a meeting at which quorum is
present shall be the act of the board.

         6. Executive and Other Committees. The board of directors, by a
resolution adopted by a majority of its members, may designate an executive
committee, consisting of two or more directors, and other committees, consisting
of two or more persons, and may delegate to such committee or committees any and
all such authority as is permitted by law.

                                   ARTICLE III

                                    OFFICERS

         1. Number. The corporation shall have a president, vice president,
treasurer and a secretary, and such other officers as the board of directors
shall from time to time deem necessary. Any two or more offices may be held by
the same person, except the offices of president and secretary.

         2. Election and Term. The officers shall be elected by the board at its
annual meeting. Each officer shall serve until the expiration of the term for
which he is elected, and thereafter until his successor has been elected and
qualified.

         3. Duties. All officers shall have such authority and perform such
duties in the management of the corporation as are normally incident to their
offices, and in addition thereto,


                                      -3-
   4

each officer shall have authority to act in the same capacity as the president
in the transacting of corporate business.

                                   ARTICLE IV

                      RESIGNATIONS, REMOVALS AND VACANCIES

         1. Resignations. Any officer or director may resign at any time by
giving written notice to the chairman of the board, the president, or the
secretary. Any such resignation shall take effect at the time specified therein,
or, if no time is specified, then upon its acceptance by the board of directors.

         2. Removal of Officers. Any officer or agent may be removed by the
board at any time with or without cause.

         3. Removal of Directors. Any or all of the directors may be removed
either with or without cause by a proper vote of the shareholders.

         4. Vacancies. Newly created directorship resulting from an increase in
the number of directors, and vacancies occurring in any office or directorship
for any reason, including removal of an officer or director, may be filled by
the vote of a majority of the directors then in office, even if less than a
quorum exists.

                                    ARTICLE V

                                  CAPITAL STOCK

         1. Stock Certificates. Every shareholder shall be entitled to a
certificate or certificates of capital stock of the corporation in such form as
may be prescribed by the board of directors. Unless otherwise decided by the
board, such certificates shall be signed by the president and the secretary of
the corporation.

         2. Transfer of Shares. Shares of stock may be transferred on the books
of the corporation by delivery and surrender of the property assigned
certificate, but subject to any


                                      -4-
   5

restrictions or transfer imposed by either the applicable securities laws or any
shareholder agreement.

         3. Loss of Certificates. In the case of the loss, mutilation, or
destruction of a certificate of stock, a duplicate certificate may be issued
upon such terms as the board of directors shall prescribe.

                                   ARTICLE VI

                                ACTION BY CONSENT

         Whenever the shareholders or directors are required or permitted to
take any action by vote, such action may be taken without a meeting on written
consent, setting forth the action so taken, signed by all the persons or
entities entitled to vote thereon. The affirmative vote of the number of shares
or directors that would be necessary to take such action at a meeting shall be
the act of the shareholders or directors, as the case may be.

                                   ARTICLE VII

                              AMENDMENT OF BY-LAWS

         These by-laws may be amended, added to, or repealed either by the
shareholders or the board of directors as provided by statute. Any change in the
by-laws made by the board of directors, however, may be amended or repealed by
the shareholders.

                                  CERTIFICATION

         I certify that these by-laws were duly adopted at the organizational
meeting of the corporation held on the 25th day of February, 1997.

                                                 /s/
                                                -----------------------------
                                                INCORPORATOR


                                      -5-