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Ok, I am sorry but I can't quit ranting. Today I got my "Performance Report" from UHC. Let me back up a few months and first tell you how UHC sent me a letter wanting me to send them progress notes, lab results, etc on twenty of their subscribers. I faxed them back and told them, as I am under contract with them to make that info available, I was not going to use my staff, my time, my copier and ink to do their job for them. I told them they were welcome to send a representative to my office, prepared to make any copies they needed on their own equipment, and we would make those charts avilable to them. About a month later, here came the rep. She took the charts into a room and spent no more than an hour going through these twenty charts.
Then today, I get my results. Of those twenty she reviewed, they found quality of care deficiencies on 6. Of these 6, one was a patient who had not had a mammogram in 2 years, one had not had a Pap last year, one had not filled any meds for over 6 months and the other three were all diabetics who they said had either not had a HgBA1C, eye exam or urine for microalbumin in the last 6 months.
So, I pull these charts myself, really upset that I would have missed these things and what do I find? The woman who had not had a mammogram lost both breasts to cancer 20 years ago. The one we did not get a Pap on had a TAH and BSO for benign disease in 2000. She is 62. The one who had not refilled her meds had at least 4 notes in her chart where we tried to contact her for follow-up and she was sent a certified letter which was also returned. All of the diabetics did indeed have all of their labs, eye exams, etc. and all were well-documented in their charts.
So now what do we do?? These are the people who are judging how well or poorly I do my job?? Something is terribly wrong here and we MUST stop this trend. I fired off a very unfriendly letter to UHC today but, I am sure it will make no difference. Until we docs get together and simply say "we are not going play your game. Take your subscribers to China or Pakistan or Timbuktu but not to me" we will continue to be raped, degraded and starved. We will never be able to continue our medical careers or obtain OUR American dream. 20 years ago these people scared us business idiots into believing if we didn't play with them we would not survive. I think it is now crystal clear that the reverse is true. We will not survive if we do play with them. Get tough, people. Your futures are at stake.

Leslie, once again apologizing for venting

Leslie,
One, I'm sorry that I am raising your blood pressure to levels similar to my own. But that being said.....
Man am I glad to have woken you up!!! I'm sure you were always aware of such things, but now you are in the groove! You are my new sister in arms with my other brothers in arms Bert, Roy and Vinny. I am so sick and tired of watching good hard working folks like you guys and my wife getting pissed on and families like ours paying the price. We stay late and don't get quality time off with our kids.

We are short on cash as our old '98 Jeep slowly rots away, but we can't afford to buy a new one. An F'ing doctor. My wife is an F'ing doctor and we can't afford to fix the roof over our family room, replace our failing fence or to buy at least a fairly new, slightly used Jeep for the crummy weather here in Syracuse, since the salt is eating our older one of two. In the year 2007 doctors sent their husbands to the driveway to fix their old beaters because they sincerely couldn't afford to pay a mechanic to do the day to day repairs. Unreal. These carriers are modern day Robber Barrons and Carpet Baggers. We need to put the shotgun in the small of their back, so as to escort them off our land, and let them know never to come back here again. They have abused the public trust for way too long. Way to go. Don't stop now.

UHC is my biggest boogieman in Health Insurance too. And don't let the AARP fool ya either. They are so in bed with UHC that they supported the republican Medicare drug plan and sell their cummy products to our seniors that then we then feel obligated to take so grandma can get her healthcare needs taken care of. how much of a kickback (illegal for us on our end, but on the selling end of insurance, that's just "business") does the AARP get for endorsing and promoting all those UHC products. Hell with managed care medicare it is "open hunting season" on our nations seniors as Maud White, the head of Nancy IPO, PO likes to say. I tell all our patients to avoid UHC like the plague that they are. They are the largest greedest company that we do business with. They post on average approximately 800 mil to about 1 billion dollars worth of profit every f'ing quarter!!! I kid you not, read the business sections sometime. That's just insane. One company, after CEO golden deals, is taking that much money out of our healthcare system for their greed selves!!! That is real money that can never go to care and can never go to a provider who provides that care. And their fee schedule in our part of town sucks too, while they keep all that bread for themselves. And the supposed savings in this negotiated freemarket is where???

I can't remember that character's full name from Network, something Beale though I think:

"I'm mad as hell; and I'm not gonna take it anymore!"

Good Night and Good Luck
Paul

Peter Finch plays Howard Beale in one of the greatest movies of all times.

Leslie, thanks. Keep venting. Paul, you really should be our Rob Liebman in Norma Rae. We talk about, but it really needs to be done.

I always wonder about the papers. Whenever I have patient that needs something, but Mainecare stops them, I tell them to go to the paper.

I have a kid with uveitis who has a very good chance of going blind. The Mass & Ear Infirmay is four hours away, but Mainecare says no, he can't go, because there are eye doctors in Maine. Yes, there are, but there are not pediatric-trained uveitis specialists in Maine as there is at the Mass Eye and Ear. I have to write DHHS, the governor and two congressmen plus out two U.S. senators. The only ones who wrote back were our local politicians. The senators and the governor couldn't even have one of their assocites write a form letter. But, I copied all the letters to DHHS, and he finally got to go. But, could you imagine that story on the front page of the newspaper. What a human interest story.

Sometimes I think I am all talk but no play. But a year ago, when I was fired up over our local FQHC who has now bought three practices and spent over $12,000,000 of yours and my tax dollars to build new buildings for them; I wrote everyone. I wrote ten medical investigative reports from D.C. to Chicago to Seattle. You would think maybe I would get one email back even if it were from the mailerdaemon.

I then wrote to DHHS in Washington, the HRSA, the Department of Justice and the Sherman-Clayton Act. Of course, being a federal government program, it's pretty hard to get anyone to listen. The Sherman-Clayton Act forwarded the letter to the Department of Justice (but that department, I believe was busy with Microsoft -- a very important dealing). My original email to the DOJ was finally answered by telephone call by a woman from the DOJ. As I had other supporting documents which shed some light on what I considered were unethical doings, she asked me to send them. She got back to me two weeks later. At least she listened to me. Ready for her answer?



Are you ready, this is great. But, it was cool to be talking to the DOJ.

She said, and I quote as I have it written down, "I understand your plight, but in the end, the federal government only cares about the financial welfare of a federal program and is not concerned with the fiancial welfare of yours." Have a nice day.

Bert,
So it was Howard Beale,thanks for the clarification. Well if you guys want me to represent you then you need to form some sort of an organization to hire me as your PR representative and be ready to show up and do strange things when I ask you to. At first it will be slow and few folks will pick it up, but with time it should catch a certain momentum. I do like your expose ideas you told me about.

Ya got to wonder where are all the network "healthcare" docs while Rome is burning? Too scared to open their mouths. I remember Jelraldo when he was sneaking into Willowbrook Psych ward to show the inmates sitting naked in their own poop. Back when he did real investigative journalism. Where is Dr Bob Arnnoy, Gupta, and Dean Adell? They have such a large audience and they don't use it. They should be asshamed of themselves.

That is a great and sad answer you got there Bert. That is one for the Media. Oh, and I'll want 4 weeks paid vacation, full traditional Indemnity BCBS, with no deductable, a 401K, a Blackberry, an expense account and a partridge in a pear tree....

Good Night and Good Luck
Paul