[In early September we posted a letter written by Kaiser victim Jupirena Stein, that had been previously mailed to Kaiser CEO George Halvorson. Ms. Stein's health has literally been ruined by a botched surgery at Kaiser, and over a six year period she has collected extensive documentation supporting her claims. Halvorson's response? Zip. Zero. Zilch. Nada. The man's organization has practically ruined this poor woman's life and he couldn't even be bothered to reply. Instead, she had to call him.
Rather than a return call from the man himself, Mr. Halvorson saw fit to have his senior attorney, Mary Parks, call Ms. Stein back, and all Ms. Parks would say in response to Ms. Stein's heartfelt letter was that "Kaiser has no knowledge of any wrongdoing." Of course they don't; they never do. Except in this case it was an even more obvious lie than usual, because Ms. Stein has certainly informed Kaiser, on more than one occasion, of copious amounts of wrongdoing.
Mr. Halvorson has been sending out weekly email updates to all of his employees, and whenever the opportunity presents itself he makes a point of saying something similar to this quote from his 5-year anniversary post: "As an organization of caregivers, we all feel collective pain any time we mis-deliver care." Every chance he gets, he also likes to repeat that he sympathizes with people who have been harmed when a mistake has been made. But actions speak louder than words, and the reality of how Kaiser treats everyone who complains certainly doesn't include the kind of sympathy that involves willingly making restitution to anyone whose life has been destroyed by Kaiser; or even acknowledging any wrongdoing, as Attorney Parks made perfectly clear. We haven't been able to find one single Kaiser member who has been treated like a human being in a dispute with this "sympathetic" organization, and believe me, we have been actively trying.
Below is Ms. Stein's latest write-up, which describes in detail the hell Kaiser put her through while trying to get her issues addressed. If you think it can't happen to you, think again. You also might want to think twice before choosing to renew your Kaiser membership now that open enrollment time is approaching, or risk finding yourself among the future ranks of the harmed and ignored.]
The first year after my surgery
Please Keep in mind that I have all proper documentation to support my words. I believe (my opinion,) that KP’s doctors are treating patients to an extreme level of lacking medical knowledge, with disrespect, intolerance, and indignity.
Here’s why:
ABOVE ALL DO NO HARM
For centuries those words from the Hippocratic Oath have guided physicians in the care and treatment of their patients. This Oath became the nucleus of all medical ethics. In its most compelling portions, it emphasizes the profundity of the medical covenant, patient dignity, the confidentiality of the transaction, and the physicians responsibility to guard against abuse or corruption of his knowledge and his/her art.
American Medical Association (AMA) Principal of Medical Ethics — Rule number 1:
A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.
What I am about to write is so absurd it is hard to believe it, but this is all true.
I did not see Dr. Wolgat, Kaiser’s ENT/Professor in charge of my surgery before my surgery — at all. I did not see him during my surgery because I was obviously under general anesthetic. I have no idea if he was there or not. He said he was. He did not come to see me after I woke up, nor for those 2 days that I stayed in the hospital.
The first thing I can remember after I woke up, was that I had the most devastating type of headache one can imagine, and Dr. Timoth Wild asking me to smile. “Smile. Smile. I need you to smile for me.” Later on I came to understand, if I would be able to smile at that point in time, he would know his scalpel did not “hit” my facial nerve. He was certainly worried about it.
My family came to see me and so did Dr. Wild. On the second day before I went home, I saw Dr. Wild for the very last time. I asked him, “My head hurts badly, did everything go ok?”
He answered, “Yes, with the exception that at one point your blood was squirting out of your neck.” I was so impressed with his words, it reminded me of the movie M.A.S.H.
For the next 10 months I was in and out of Kaiser doctor’s office, at my request, being sent from one to another to another doctor. All of them told me that I was OK. That I was perhaps in need of psychiatric help because I could not accept the fact that I was diagnosed with cancer.
All of them lied to me about my injury. They “worked” carefully together, and all of them hid this devastating vascular injury from me and from my family.
NOTE: Ten days after my surgery Kaiser Permanente Pathology, come up with the diagnosis of a rare type of cancer (at that time) named Acinic Cell Carcinoma. It was found in my parotid gland, and involved 1 lymph node. KP cancer diagnosis is our next subject.
THE RADIOLOGISTS:
These doctors listed bellow interpreted many of my x-rays. Two of them, taken months apart, have the exact same wording. Only the dates had been changed as if there is a format for these things. None of them ever once mentioned in their reports that my sternocleiomastoid muscle was getting atrophied and my shoulder bones had fallen drastically out of place.
Dr. Deborah Anne Kass — License G40970
Dr. Daniel Edward Siedler — LN G49122
Dr. Chi-Wai Gerry Kwok — LN A50513
Dr. Richard Joseph Gabbay — LN G37772
Dr. Larry Edward Yeager — LN C39192
THE NEUROLOGIST:
Dr. Jeffrey Javerbaum — LN G33682
ON February 28th, of 2000, he did an EMG (needle electromyography) study on me to properly diagnose and answer my questions about what was happening to my sternocleiomastoid muscle (the big north/south muscle on the neck). Was it getting atrophied? My sister was with me.
His report says, “No atrophy or weakness. Clinically, I suspect that this is quite possibly a brachial neuritis” (BN is a rare syndrome of unknown etiology affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches), and he continues, which is reported post-op (after surgery) in any location. It amazes me how much Kaiser likes to diagnose me with rare cancer and rare nerve condition.
Dr. Javerbaum — in front of me and my sister — tampered with the computer and changed the exam printout. Then he handed me a copy of this EMG results and said, “See? There is nothing wrong with you.” He recommended a shoulder sling, and that I try Tegretol (which is an anticonvulsant often prescribed as a mood stabilizer for those with bipolar disorder).
THE RHEUMATOLOGIST:
Dr. Alan David Lash — LN A35820
Dr. Lash injected cortisone into my shoulder. I still don’t know why. I insisted that he would not. At one point he said to me, “How are you ever going to know what is causing your problems? This is a process of elimination.”
When I asked him about the missing muscles on my neck and shoulder, just a few inches away from his eyes, he said to me, “I do not see whatever you see.”
THE PATHOLOGISTS:
Dr. Sudha Krishnamurth Rao — LN A54908
DR. L.T. Smyth – LN G40382
These 2 idiots diagnosed me with cancer in one lymph node THAT DOES NOT EXIST, causing me to have radiation treatment needlessly.
THE ENTs ( Ear, Nose and Throat doctor):
Dr. Harold William Korol — LN G17963
He was Kaiser Redwood City ENT Chief at that time. One would think that he, better than anyone else, would know what was causing me to getting sicker and sicker after my superficial parotidectomy surgery. I never expected him to lie to me and on top of that be so cruel. I saw him several times. He said I was fine and insisted I should go see a psychiatrist.
Dr. Robert Alexander Wolgat — LN G47484
He is the doctor that told me before my surgery that “Your gland is swollen. This gland duct often gets clogged. It almost never gets better. There is a doctor here that can remove this gland for you.”
Dr. Wolgat was the teaching ENT surgeon for KP Redwood City, California. 17 years of experience, he said. He did not supervise Dr. Wild, and I suspect he was probably not even present during my surgery. After my surgery I saw him several times. Each and every time he lied to me about my injury. He said repeatedly to me, “You will get better, just be patient. You will get better.” Over and over, for about 10 months.
THE SURGEON — he signed my surgery report:
Dr. Timothy Wilfred Wild MD, DDS — LN A61573
Was a resident at KP Redwood City, California, at the time of my surgery. It is beyond me that a dentist/doctor, specializing in ENT at KP can do such a devastating medical error. How could he have mistakenly dissected a major artery?
On his surgical report, Dr. Wild described how he “hit “my carotid artery or possibly my external jugular vein, this way: “…and then, there was a large vein sitting on top of the trunk of the nerve, I dissected it and sutured ligated it.” A large vein? Didn’t he know its name?
Mr. Bailey, my former attorney, missed this important information and ended up claiming a less important NON-EXISTING SEVERING of the spinal accessory nerve.
Today, Dr. Timothy Wilfred Wild is fully employed by KP Vallejo, Northern California, and he is the Chief ENT surgeon. Dr. Wild can be reached at (707) 651-1000 (ask for Head and Neck Department) or at the KP Vacaville Medical Center at (707)453-5000. Please call him and ask for his side to this story.
THE PHYSIATRIST (a doctor who specializes in diagnosing and treating problems of the musculoskeletal system, except for those physiatrists that work for Kaiser Permanente):
DR. William Lawrence Firch — LN G61851
How should I start talking about this quack? Please remember that by the time I saw Dr. Firch, my sternocleiomastoid muscle was already gone. My shoulder bones had dropped, I was having problems breathing, swallowing and my heartbeat was already out of rhythm. Dr. Firch ignored me. He had in his possession all my x-rays, MRI and CTs that showed all that I have described above.
I wish you could read his report. He says, “…she has had electro diagnostic evaluation through Dr. Javerbaum [the neurologist that did my electromyography and tampered with the computer to change its printout"] which did not demonstrate specific abnormality.”
And he continues, “…this pain she feels is all in her mind.”
He recommended that I take Valium. One would think he would be interested in CCing his report to my neurologist or my orthopedic surgeon right? No. Dr. Firch CC’d his report to my physical therapist and my gynecologist. Amazing!
Last but not least,
THE ORTHOPEDIC SURGEON:
Dr. John Bordy — LN G13812
After reviewing my x-rays he recommended that I see a chiropractor.
By the time I saw Dr. Bordy I was very sick. It became clear to me that something was dead wrong with my health and it was even more clear to me that Kaiser Permanente’s doctors were NOT going to help me with my deteriorating health. I never went back to Kaiser again.
———————
On October 6, 2000, I saw Dr. Michael Cohen, a private neurologist (outside of Kaiser.) That day, Medicare started paying for Kaiser’s mistake and to date still is. I requested, crying and begging him to tell me the truth: “What is happening to my body?” He told me that my sternocleiomastoid muscle had been atrophied to nothing and that he suspected nerve trauma.
I decided to get an attorney’s opinion of this “nerve trauma,” so I called the Blackman Law Group in Burlingame, California, at (650) 692-8124. Unbeknown to me, the corruption and fraud continued.
Mr. Blackman became very concerned that I was publicly involving his law firm’s good name with the word fraud, and in my opinion he was was not able to understand my reasons behind why I never signed Kaiser Permanente’s award check for $75,000.
As per my readings of reliable resources, literally every day thousands of patients throughout our country go under this kind of abuse from Kaiser Permanente. I know many patients personally that have a similar story to tell.
Do you know why KP gets away with this type of professional behavior? Because the DMHC and the California Medical Board allows them the privilege to.
In my opinion, either ALL Kaiser Permanente doctors that I mention here are obscenely incompetent, or they normally, openly and freely use medical corruption working together among themselves, taking their questionable medical behavior to the extreme levels of patient abuse — at all costs, hiding the devastating medical errors of their colleagues.
There are just no two ways about it.
Jupirena Stein
Kaiser Thrive Exposed would like to personally thank Dr. Geoff Galbraith - Kaiser Permanente Care Management Institute board member; and Vice President, Hawaii Permanente Medical Group, Quality Improvement Management - for inspiring us to create this website. Did we make it into the top 5?
“As an organization of caregivers, we all feel collective pain any time we mis-deliver care.”
He is half right. WE — the caregivers — do feel that pain. WE are the ones who have to deal with inadequate staffing and antiquated resources. WE are the ones who have to deal with doctors who really don’t care about their job anymore because they are so determined to make as much PROFIT as possible — not health care. WE are the ones who have to learn a new computer system every time the new (NON nurse) CEO decides they know what’s best for nurses.
And after 12 hours a day when a doctor orders the wrong dose for a patient and WE don’t catch it in time, WE — I — do feel PAIN. Not collective pain. PAIN. HORROR. That all the money is being spent on CEO bonuses and company cars and VIP perks and DOCTOR PROFIT SHARING. And since that money’s being wasted there it isn’t being spent on hiring enough nurses to catch medical errors and enough pharm techs to catch medication errors.
so please spare me the “COLLECTIVE PAIN” the “caregivers feel” speech. The CEO isn’t a caregiver. He’s a careTAKER. He can’t apologize to this poor woman who has had her life ruined. He can’t look her in the eye and say He’s sorry. Because he’s not. Because it’s his fault and he knows it.
I am very sorry for what you had to go through and what you continue to go through.
I don’t understand for the life of me how this organization can claim to be “care givers.” By the time the victims get through
sorting through the altered medical records and constantly changing “facts,” they don’t know up from down. Facts aren’t really facts if they are not actual facts, am I right? This rewriting of history is even more dangerous than what the condition would have been without having any care at all! What is the point of seeking care if the motive by the caregivers is to cover their *ss, and let’s not forget, make a profit? Where is the value in that for the patient? There is NO value in a system
like that. NO VALUE. Who wants to spend money to have their life ruined?
It is unfortunate that the good nurses and caregivers, the ones who truly are good people and who truly are trying to do a good job, get caught up in such a corrupt system. The lack of staffing and resources starts from the top. EVERYONE else has to do the cleanup and pay the price. Unfortunately, the good guys at kaiser are being taught how to be bad. And that’s what corruption does. Corruption disrupts.
“But actions speak louder than words, and the reality of how Kaiser treats everyone who complains certainly doesn’t include the kind of sympathy that involves willingly making restitution to anyone whose life has been destroyed by Kaiser”
ABOVE ALL DO NO HARM. The day this becomes the motivation for kaiser will truly be a miracle right here on earth (and I say that with hope and anticipation!!!)
First though, the weeds need to be weeded out at the root.
It is the epitome of poor taste and does show lack of proper training when any corporate representative acts pompously and affects an attitude of distance from the consumer. In this case the patient-consumer.
Mr. Kaiser would never have conducted himself in such a poor manner. Mr. Kaiser was known for personally going to the people and making sure that they were doing well, and were being well cared for, especially when serious medical matters were involved.
George Halvorson is trained first as a reporter Certainly he should want to investigate what his corporation has done to Ms. Stein.
Maybe the following will help to make it clearer to Mr. Halvorson - the reporter - in case he truly has been left in the dark or has justified his actions to himself in order to retain his corporate contract.
A number of people have seen the Stein medical documents - Kaiser’s set and sets obtained independently from Medical Authorities both within the United States and other countries which tell the true story. I believe that anyone at Kaiser would be hard put to challenge the source of these documents.
The true story is that if any Kaiser doctor accidentally created this problem, then the doctor was sword fighting with his scalpel during the surgery. But if that were true with what medical authorities have since written in documents, Ms. Stein would not be alive today. That leaves only one other conclusion and that is this was not an accident. That makes it a crime.
Here are some short facts, written here by one who has a copy of the documents and does have permission to write about some of them:
1. Regarding the alleged cancer diagnosis made weeks after the surgery - the material provided by Kaiser was found by pathologists (note the plural) to have been obtained from another part of the body - far from the neck. Also pathologists have made a point of noting that the original slides provided by Kaiser and labeled as containing tissue that is part of Ms. Stein have another label underneath. That original label belongs to a man and his name is nothing similar to Stein.
2. Dr. Wild was not Board Certified during the surgery. He did obtain Board Certification after the surgery and shortly thereafter became Department Chief. Pretty good for a physician just starting out.
3. Four arteries and veins were severed at a location remote from the site of surgery. These four vessels were repaired with four different methods. These are the procedures required for Board Certification in Dr. Wild’s field which had not been satisfied until this operation. A question justifiably arises if this was an accident or a motive to satisfy certification requirements.
4. Ms. Stein probably would never have known, nor have had a major medical problem if one of those arteries had not been put back together so poorly as to have seriously reduced arterial blood flow. That is what happens when you kink a tube inside an artery and can’t straighten it out again. You can’t just pull it out either to put in a new one without making the problem worse when it’s in such a location.
Of great interest to a number of people is why in the world this physician would have used a material to stent one artery that clearly shows up on an MRI and other modern forms of imaging that was not approved for use internally in that time period but was being used internally for experimental purposes on animals. None of those animals that had this done to them lasted very long. Ms. Stein has suffered greatly.
So Mr. Halvorson, the reporter, what do you think happened? Was it a way to satisfy a physician’s board certification or was there some experiment going on? It certainly does not appear to be any accident.
Ms. Stein wants to talk to you about this. She even would be very happy to show you the proof so you would know first hand what your company is involved in.
After the way she has been treated by your employees I think that a phone call from you is the least that she deserves.
After working in both Kaiser hospital and clinic in Sacramento, Ca., starting in the mid 1980’s to 1993 it has certainly been never ending nightmare, listening to patients and employees who are patients, that kaiser now entering into decades of operation, gets worse by the day. It baffles me that this can go on in this civilized world! What happened to Ms. Stein can happen to anyone. So far Kaiser has mananged to kill off at least 7 of my family members while charging medicare for hospice, morphine and other durable goods that were of no use to them and the same went for employees who have died because of deliberate medical neglect. Many of the ‘DOCTOR’s who worked in the hospital were interns and residents. IT was a very rare time that a staff doctor would visit their own patients upon and after admittance to the hospital. Many patients waited hours upon hours in the ER because the staffing was so poor in all departments. This has been one of the ongoing parts of the problem. Whenever the hospital staff needed extra help or anything related for the patients needs, we would be told it was “not in the budget”. I guess that has been one of ways Kaiser-a-non-profit has been able to amass billions, by denying basic needs for the patients which comes in a myriad of negligent and criminal acts. When the patient like Ms. Stein dared to ask or as Kaiser would consider an automatic rebuke or challege to them, they would automatically consider the patient for pyschiatric care-an intimidation, or acts of retaliation. Make the patients non credible to deny Kasier’s deliberate malpractice. Employees unfortunately suffered the same by sending them to psyche doctors and stuffing them with meds that would make them uncredible, immobile and unable to fight for themselves. Kaiser has a method of operation or as the police call it their MO, lie to maim and kill and then always, DENY, and of course , it is all for their profit. Medicare is Kaiser’s very own “permanente” personal ATM. I call it the kaiser killing fields #1 just to milk the public taxpayers out of billions of dollars for it’s own adminstration and it’s doctors profit.
The state of California and it’s agencies like CMS-DMHC-DOI, the judical venue and it’s legislators have turned a blind eye to the horrors like Ms. Stein has had to unnessarily endure. The people who are supposed to protect the public and patients have done an abysmal job just to have a job with benefits and hopefully they don’t or won’t depend on Kaiser for their healthcare because they are not immune to the same criminal malpractice that happened to Ms. Stein and so many others. That and maybe, just maybe, STATE EMPLOYEES WHO ARE ON on Kaiser’s hit list like the rest of kaiser patients which would be to eliminate them and or their families cause these state employees would know too much about the REAL KAISER!
I profoundly applaud and greatly appreciate her humanitarian efforts and contribution to our healthcare society for Ms. Stein’ efforts to expose the real Kaiser which is nothing but a #1 lying deceitful sieve for the obvious-billions of american tax payer funded dollars that criminally amasses more and more by eliminating patients through experimentation and flat out killing and PERHAPS most of all while enduring the repercussions of Ms Stein’s Dr. Mengele type of surgery and substandard care by Kaiser, albiet the poor quality of life that Kaiser left her with, she is still alive and perservering.
I can only hope and pray that we all like Ms. Stein, live long enough to see the United States Congress and other top gov’t officals do it’s job BY GIVING deserved restitution to the patients and their families and shut the kaiser killing field DOWN!
Dina
This part freaks me out the most. Ms. Stein was obviously an unknowing GUINEA PIG who was EXPERIMENTED ON. Why is Northern California so full of medical corruption? What Halvorson is feeling is COLLECTIVE INSANITY. Lets hope he takes his Haldol daily!
>> Four arteries and veins were severed at a location remote from the site of surgery. These four vessels were repaired with four different methods. These are the procedures required for Board Certification in Dr. Wild’s field which had not been satisfied until this operation. A question justifiably arises if this was an accident or a motive to satisfy certification requirements.
Sure looks like a motive to satisfy certification requirements.
Too bad Ms. Stein didn’t agree to being used as a guinea pig FIRST.
How noble of them to jump right in and take over her body.
That’s for the information on Dr wild, I looked up his web site, WHAT A HOTTIE!!
Hey “Julie” — next time you try to impersonate a Harvard doctor, you might want to keep in mind that I can tell when it’s the same person posting comments with multiple names & email addresses, and that your location is nowhere near MGH. Your fake comments were deleted, but I left the silly one above as an example of your superior intellect. Nice try, dear.
Let me add that your gift for remote diagnosis of a patient you’ve never even met is truly remarkable. You oughta take that act on the road. (Unless of course you have met her, which just makes you a creep).
Sounds like a lot of bogus information from people who are not even doctors. See if you publish this one, I doubt it. If anything is creepy it’s this site, I read it for entertainment. Sort of like watching the Jerry Springer show! Guarantee you won’t publish this, only what fits your agenda, right? What a hypocrite you are!!
[editor's note: This lovely human being accessed from Kaiser Permanente IP address 162.119.64.113, via a Yahoo search for *Timothy Wild MD* at 12:33pm Pacific time. Dr. Wild himself doing a vanity search, perhaps? Or maybe just a co-worker who likes to impersonate Harvard doctors, that suffers from some sort of bizarre fixation on "hottie" Dr. Wild. Thanks "Pam" for another stunning example of the sociopathic lack of compassion Kaiser's health care "professionals" have for their victims. Keep up the great work...makes our job here much easier.]
Sounds like another sicko on the loose! What a CREEP. Coming from KP, let’s consider the source. A person would have to be beyond sociopathic to do the things certain kaiser folks do.
Yep I’d say, this just validates your existence Admin.
Keep up the excellent work! Our safety depends on it.
[...] leading to much unnecessary suffering and sometimes death. A few recent examples are the cases of Jupirena Stein, Craig Pozzi, and a woman with West Nile Virus, who was repeatedly told her symptoms were all in [...]
The creep is George Halvorson.
I sent him an email one time, and he actually responded. The email I sent detailed how my wife was ‘treated’ at a Kaiser facility.
His response? ‘That can’t be Kaiser.’
The sad thing is, he’s the one who is pushing for universal health care. He’s the one leading the charge. If he gets his way, we may as well all just take a cyanide pill.
Hey Ms.Stein,
I’m sorry for the way these people treated you. It is DEFINITELY against the law and DEFINITELY a criminal organization.
I can’t imagine what you went through when you found all this information out.
My prayers go out to you. I’m not like all the other people who say “we can only pray….” and they don’t anyway. I am a serious Christian and I know that my prayers get answered, so if there’s ever anything I can do for you other than pray,
please just let me know. I’m sure this website has my email address and they will let you know.
This is wrong and SOMEONE should make a stand. We need to start a RIOT against this place. I mean, your story, a story of a stillborn child because the patient wasn’t treated??? Not right. At least not according to the Constitution or Medical laws.
I hope you get the chance to read this and I hope that everyone else who reads my comment and has been a Kaiser victim will make a stand and not be afraid to RIOT outside their door.To NOT be afraid of sueing this place for all they have. You need PROOF,DOCUMENTS,(recordings would be SOOO awesome!), whatever you can get your hands on, and go to court.
This cannot go on. They’ve been in business way too long.
My deepest sympathy goes out to you,
in Him,
Hannah
Dear Ms. Stein,
Your story broke my heart. We pay our premiums in good faith. We want to trust our doctors. What happened to you is, well inconceivable. I hope and pray that you get better. I will send you good thoughts and wishes with every cell and fiber of my being. Kaiser ruined my health, as well. I have been treated and regarded as a mushroom. My story cannot compare to yours, yet. Just tonight I suffered from a serious drug interaction that was condoned by a Kaiser pharmacist. My husband is an EMT. He saved me. I have to believe that somehow Kaiser will be held accountable. Most of all, I wish you well. I wish you heal. I hope you feel better. I put this out into the universe.
Sincerely,
Glynis Tolson
I have just completed reading Ms. Stein’s story regarding her treatment at Kaiser facilities and the “qualifications” of her treating (and/or consulting) physicians. I am appalled and horrified that she had to endure what appears to be a continuing nightmare of medical treatment. That she is no longer a Kaiser enrollee speaks only to her acute sense of right vs wrong and her ability to continue to fight for her rights to be treated with dignity and respect.
I am a former Kaiser employee who wore the badge and title of “Auditing Specialist”. My qualifications for wearing this badge included the fact that I was an Registered Nurse (for over twenty years at the time of my employment with Kaiser) and a certification of CCS-P (certified coding specialist) attained through intensive studying of the codes used for diagnosis and treatment of all diseases recognized by the DSM-III manual (listing of all known medical problems/symptoms for which a person seeks medical treatment for improvement/cure of their distinctive problems that have been recognized by the American Medical Academy and the Health and Human Services department of our government. (There has probably been some changes in this manual since my employment, but the general concepts remain the same as the intended original.)
As an Auditing Specialist, I and my co-workers (some without the extent of qualifications that would seem necessary to perform this position) were responsible for reviewing the medical records for physician office visits to determine whether the documentation in the record “matched” with the patient’s presenting symptoms and/or chief complaints at the time of the visit. It may not surprise most of you that this “match” was rarely met (if you could even begin to decipher the physician’s handwriting!). Office visit notes were scribbled at the time of the visit (probably no longer than the 5-10 minutes allowed per patient to ensure that the MD could see the maximum number of patients in ant given day).
If a diagnosis was even mentioned in the record it was an unusual occurrence. Treatment plans usually consisted of “return to clinic PRN” which means “as needed”, leaving the decision of whether further medical testing and/or treatment was “needed” to the discretion of the patients and significant others rather than to the physician to whom this responsibility is given at the time they take the Hippocratic Oath to “at first, do no harm.” While giving this responsibility to the patients, Kaiser was able to delay, postpone or make extremely difficult, the ability for the patient to make return appointments or receive a referral to appropriate consulting and treating specialists. Urgent Care employees, when questioned about the lack of appropriate documentation in the medical record, were not surprised, nor were they the least bit supportive of, the manner in which the physicians conducted and documented these office visits!! Given the opportunity to vent their opinions, it was apparent that most of the employees had very little faith or confidence that the patients were receiving the appropriate care in a timely manner (remember, each “visit” was limited to 5-10 minutes — if a patient could not express themselves clearly or did not have the ability to speak quickly and to the point about their symptoms, they were in the hallway, after seeing their doctors,looking dazed and perplexed about what to do next!!).
In many instances, they were not even seen by MD’s, but rather by the Nurse Practioner in that particular MD’s office. (Drop by the Kaiser outpatient offices at The Orchard Medical Offices in Downey, CA (Southern California Kaiser Permanente Medical Group) and you will see a steady stream of patients at all hours of the day and night!)
It would take reams of paper to even give a synopsis of the types of “errors” noted in the medical record and the corresponding charges requested by the MD. Yet, when these discrepancies were addressed in our audit reports, we were instructed by our supervisors and upper management (including the esteemed Medical Director of the group practice) to “find a way” to justify the charges or “look at it another way”. It is my firm belief that Kaiser has charged for services that were either not provided or where shabbily done. Let’s not even address the co-payments required by patients, to be paid at the time of the visit, or be charged an additional $15.00 for the privilege of being billed at a later date.
As you may have gathered by now, I am no longer employed with Kaiser and if I had not resigned my position, would probably have been fired for my thorough review of the records I reviewed. I did not hesitate to speak loudly and frequently about the discrepancies I had found — and, as such, was not viewed as a valuable asset! (In fact, I had been “disciplined” and given poor performance evaluations for essentially doing the job that was required of me — audit for the complete and accurate documentation in the medical record).
I had been, until 3/1/08, also been a Kaiser enrollee, receiving all my medical treatment from Kaiser physicians. I remember one time very clearly, after one of my “scheduled” appointments with a primary care provider, literally screaming at him regarding his lack of attention, while he showed me to the door. Didn’t do much good anyway — I had joined the Kaiser sheep fold and literally had no real recourse available to me. I admit that I held on to my Kaiser benefits for a long time simply because my employee benefits far surpassed any other type of insurance I could have obtained. My co-payments were ridiculously low!! I had surgery 3 times for recurrent bladder tumors, and paid only $5.00 for all of the inpatient services I received — including surgeon fees, anesthesia, medical supplies, and any other associated costs. How did Kaiser manage to keep my charges so low?? They were able to do so only because of the majority of their enrollees were paying upwards of $700 per month for their insurance benefits. To say that my health care was subsidized by the silent majority says it all!!
I must apologize for generalizing and making it appear that ALL Kaiser physicians acted as depicted above, for I was fortunate to receive treatment from some very qualified and professional physicians — but, because of my auditing experiences, I knew which MDs met their responsibilities and could selectively choose whom I entrusted to care for me. It is with deep regret that I acknowledge that the majority of Kaiser enrollees do not have the advantage of this knowledge, and are made to endure the horrific experiences as outlined by Ms. Stein and others who have posted comments on this invaluable Web site.
I am afraid to say that the only ones who “THRIVE” at Kaiser are the physicians who comprise the FOR PROFIT medical groups!!
I also apologize for this lengthy post and would like to thank everyone who had the patience to read it in it’s entirety–
I wish all current and past Kaiser enrollees the opportunity to have their medical needs addressed in a timely manner by professional and competent health care individuals. Alas, I cringe to admit, this may be possible only OUTSIDE OF KAISER!!
Best wishes to you all,
CTJ