We received an interesting comment today, left by a Kaiser Permanente physician on Donna and Jack Berlin’s post about their son Sean’s death at Kaiser Walnut Creek.
Robert accessed the site via a Google search for “Robbie Pearl” (the head of TPMG), and he identified himself as a “non Kaiser physician,” despite proof from our traffic logs that he was posting from a KP facility. He then went on to praise Kaiser and imply that sites like ours that criticize KP contribute to insurance companies spreading the fear tactics that interfere with health care reform. Huh? Did he forget that Kaiser Permanente is in fact an insurance company, otherwise known as an HMO? Kaiser supports health care reform all right, but only based on its own corrupt model, which incentivizes the withholding of medical care and then forces patients into its rigged mandatory binding arbitration system to deal with the fallout. How he believes this will lead to a medical system with LESS negligence in it is anybody’s guess.
Anyway, we think the exchange is important enough to deserve its own post for a couple of reasons. First, because someone needs to call these people on their BS. And second, because we often receive comments like this, arguing from the logical fallacy that KP shouldn’t be criticized because the same problems occur elsewhere in our medical system. That whole “but everybody else is doing it” defense just doesn’t fly.
We’ve said it before and we’ll say it again: It is not impossible to get good medical care at Kaiser Permanente. What IS impossible is getting them to take responsibility and make restitution when something does go wrong. And THAT in a nutshell is what makes Kaiser Permanente’s health plan and health care provider in one model more harmful than most other insurance companies. Our reply is below.
First, Robert’s comment:
I am a non Kaiser physician from Massachusetts potentially joining this organization, and objectively it seems that these problems are more with the medical system itself, rather than with Kaiser. Kaiser is an easier target because it is so big. If you think the problems mentioned above are scary, you should see what I see as a medical insider. Believe me when I say Kaiser does not hold the corner on the market of negligence. It is universal. Kaiser unlike other private practices does not provide incentives for their physicians to do more procedures. Whether you know it or not, this is a large source of complications and bad outcomes. As a for instance – a cardiologist saw a patient that came in for a slow heart beat. This physician stands to make money when he/she puts in the pacemaker. He/she ignores the fact that this particular patient’s heart rate is slow because of medications she is on. The pacemaker gets put in anyway. This patient then develops an allergic reaction to the tape on the dressing. The pacemaker wound then gets infected, and eventually the pacemaker itself. Within days, the infection is now in the heart forming an abcess. That is where we stand now.
I only point this out to show that there are far reaching problems that extend to all of medical practice. And while there still will always be bad outcomes, because nothing is perfect, I think at least some organizations make an effort to prevent that which is preventable.
Insurance companies do not want Obama’s reforms to go through because they are making tons of money with the current awful broken system. So fear tactics are employed. A website like this contributes to the fear tactics.
I am sorry for your loss, and if this was indeed preventable, we need to change our medical system so that this sort of thing doesn’t happen again.
And our reply:
Repost of a comment I wrote for the front page USA Today article about missing medical records in Beth Stover’s case:
Kaiser is different from traditional insurance in that the doctors essentially ARE the health plan (they would tell you differently) due to a deliberately deceptive organizational structure and physician profit-sharing. Most of the denials we hear about are from doctors ignoring patient complaints, or failure to treat or order necessary tests. Because of peer pressure and identical training a patient can seek a 2nd, 3rd or 4th opinion inside Kaiser and always get the same answer.
This creates a barrier between the patient and the health plan (Kaiser is all about barriers), prevents more complaints from making it to official grievance status, and allows Kaiser to claim health care decisions are only made by doctors. It’s not technically a lie, except that they have so thoroughly dumbed down the standard of care, and because they’re all in on it, the end result is the same as an insurance denial.
We’ve heard from lots of people who end up paying out of pocket to see a non-Kaiser doctor, who will order up the tests just like that and diagnose a problem that Kaiser may have missed for literally months or years. They miss it because they automatically treat every symptom as if it comes from the simplest, least expensive cause (chest infection vs. lung cancer for example). You could say the odds are on Kaiser’s side because most medical problems aren’t life threatening, and will clear up on their own without any intervention from a doctor at all. With the mandatory binding arbitration requirement, and Kaiser’s unlimited legal budget, they can easily slap down most cases that do make it to a lawsuit (they control ALL of the evidence and alter it at will), and even with an occasional big loss they will always be way ahead financially over treating the patients fully in the first place.
Robert stated that “Kaiser unlike other private practices does not provide incentives for their physicians to do more procedures.” Well no kidding, I think the taped conversation that John D. Ehrlichman had with Richard Nixon about KP’s business model made that fact crystal clear:
Ehrlichman: “Edgar Kaiser is running his Permanente deal for profit. And the reason that he can … the reason he can do it … I had Edgar Kaiser come in … talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because …”
President Nixon: [Unclear.]
Ehrlichman: “… the less care they give them, the more money they make.”
President Nixon: “Fine.” [Unclear.]
Ehrlichman: [Unclear] “… and the incentives run the right way.”
President Nixon: “Not bad.”
Kaiser would like the public to believe there is no incentive for its physicians to deny medical care. But what Robert failed to mention is that the Permanente Medical Groups, which employ the doctors, are the FOR PROFIT third arm of the Kaiser Permanente triad (the not for profit health plan and hospitals being the other two).
The for profit Permanente Medical Groups receive payment from the health plan, and the percentage of those payments that makes it into the doctors’ pockets just happens to have an inverse relationship to how much care is provided. So no, there’s no memo line on the check that reads “For Medical Care Denied”, but the incentive is implied in the math. So let me repeat: the doctors essentially ARE Kaiser Permanente, and they are FOR PROFIT. See how Robert’s intentions for posting here suddenly seem so much more clear?
So there you have it. Makes you want to run right out and sign up for Kaiser!
[From the original comment thread]
On the surface this comment by “Robert” appears to be a reasonable difference of opinion. The only problem is that this “non Kaiser Physician” happened to post it from a Kaiser Permanente IP address, specifically 162.119.240.100.
This, ladies and gentlemen, is what is known on the internet as a concern troll–
And not a very good one at that. I’m sure you didn’t intend to reinforce negative stereotypes of KP physicians as less than truthful, but that is indeed the result when you post something like this without disclosing your true ties to KP.
We don’t oppose health care reform. In fact we are some of the biggest proponents of single payer universal health care (with private delivery) for all. What we vehemently oppose is Kaiser-style health care reform, and insurance companies killing people for profit. Big difference that.
Not me.
Don’t overlook how abused K-P physicians are. Physician’s in the trenches are seeing patients every day. K-P decides how much time doctors have to see a patient,medically untrained phone servers make appointments without any idea of how long it takes a doctor to make a diagnosis. This encourages poor docs (and there are many, everywhere, not just K-P) to move the person around the system like a item floating in a whirlpool. It also encourages misdiagnosis from the pressure to see too many people in too short a time period. I encourage KaiserThrive to investigate the turnover in primary care state by state. The numbers are awesome. Look deeply into any numbers you get and demand to see how many docs are actually seeing patients, rather than moving around the system doing ‘administrative work and/or work on the electronic medical record’.
You are absolutely correct about that, Bev, and the younger, newly minted doctors take the brunt of the abuse. Those who wish to retain their personal ethics rarely last at KP, and the ones who stay long enough to make it to senior partner have been so thoroughly Kaiserized by then that they turn into abusers themselves.
Just take a look around at the various scandals we have reported on this web site. One of the more disturbing trends is the retaliation suffered by KP physicians and others who have tried to address the internal problems and protect the best interests of the patients.
Kaiser doesn’t make changes because it’s the right thing to do. They respond to two things: loss of members (read: money); and bad publicity. That is why the idea that criticizing KP is a bad thing that jeopardizes health care reform is so freaking ridiculous!
1. It is true that to “err is human” and that health care providers do no intentionally set out to do harm.
2. It is, however, necessary to avoid harm from errors by following clinically proven best practice
3. It is necessary to mitigate mistakes when errors occur to avoid harm (Institute of Medicine)
What makes Kaiser dangerous pertains to numbers 2 and 3. (2) Kaiser will follow the least expensive, not the clinically proven best practice, even if their least expensive care has more of a potential to cause harm. (3) Kaiser will cover up mistakes rather than admit the errors they have made and mitigate the damage.
I personally experienced this in relation to a horrible series of events with my daughter’s healthcare. A physician had misdiagnosed my daughter by not following the Standard of Care and failing to order adequate diagnostic tests to verify the diagnosis. She then prescribed the most toxic, but least expensive treatment for that condition resulting in permanent damage of my daughter’s lungs. Given the information the doctor had at the time, the diagnosis for which my daughter was treated was not even in the physician’s differential diagnosis.
We did file a grievance against Kaiser. A Customer Service Representative informed us that Kaiser’s Medical Review Board denies every grievance. The patient then must make an appeal and hire an attorney to go through arbitration process. It is almost impossible to find an attorney to take your case unless Kaiser killed the patient or the patient is basically non-functional and SOMEONE WITNESSED IT and had the courage to come forward and tell the truth. Of course, this would cost the person his/her job and perhaps his/her career.
My response to the Medical Review Board was, “Please add this letter to my grievance as further clarification as to why I don’t believe Dr. XXX provided “excellent care” to my daughter. Given the details presented herein, I don’t understand the reasoning of the Medical Review Board. Of course, I am not unfamiliar with Health Care Providers denying the obvious in order to protect their vested interest and protect one another. I find it to be a conflict of interest and a near impossibility for a Medical Review Board made up of practitioners entrenched in their own organization to impartially review such cases.
This post and this site are just stupid. Kaiser isn’t perfect but millions of people and 1000s of doctors like it. Of course a company needs to control costs and make a profit. But this is counter-balanced by reputational problems due to lousy care. And by the fact that most reasonable people want to see people be healthy.
The energy put in to this site is mis-placed.
Well, John, everyone is entitled to his own opinion, and mine is that you didn’t look around this site enough to know if the energy put into it is misplaced or not.
From my logs I can tell you came from Facebook to the main page, clicked through to the comments on this post, then posted your comment above. This leads me to believe your opinion was formed before you even got here.
“Reputational problems due to lousy care” are what we write about here. Where exactly does the counter balance come from if no one publicizes the problems?
Comments like yours always come from Kaiser employees. We have never denied our bias, but perhaps you should be more forthcoming about yours.
John, have you been a patient at Kaiser? Have you lost a loved one at Kaiser? If not, then your comments are entirely too stupid for words. I suggest you try it for yourself and see if you like it, but be careful, you could lose your life…but that would be stupid, wouldn’t it?
My husband and I have been with Kaiser for two years and we are now changing health plan. We do not like Kaiser. They do not provide the best treatments available but the most conservative, old and often dangerous for your health. My husband had a nail infection that could be treated with laser in one time visit and the Kaiser doctor instead prescribed a medication for three months that had high potential to damage the liver….. Every time you need to see the doctor, you need to talk to a nurse on the phone…. and you can never choose your physician. The best ones don’t accept new members and you end up with those that just finished their residency….
We are changing. I don’t feel Kaiser is in our best interest.
Francis, sounds like Kaiser is up to their usual and dirty tricks. Preventing you from actually seeing a Doctor is just part of their scheme to avoid having to actually provide care. They just want your money, that’s it. Once they have that, there is no need for them to provide care. As for the nail infection, this sounds to me like just another one of their schemes…to make sure THEY spend as little time and care and treatment on their paying members as possible. They do not care about putting patients in harms way…remember now, it is NOT about the patient and what is good for the patients health. IT IS ONLY ABOUT THE MONEY. This is why Kaiser is in business. I learned this the hard way on March 3, 2006 when kaiser carelessly and negligently let my Daughter die. If you are in California, there is even less incentive to provide actual care due to California’s $250,000. MICRA cap. They would rather you die than provide care because this will save them money as well.
I was born at kaiser in 1979 and was a member until 2007. kaiser and there cost cutting cost me my quality of life!! Since Kaiser is all i knew i thought i was getting the best. At this time i can not elaborate on my exact circumstances and numerous horrid medical experiences but i am permenently disabeled and was only able to switch health plans beacuse i am on MEDICARE.I hope to prove with my lawyer that kaisers responsible. I hope soon to be able to share my full details.
Yes, Kaiser indeed falsifies records. This includes deleting records, inserting comments long after the date of entry(you can tell), writing fiction to cover Kaiser docs’ behavior.
I have seen entries mangled, merged, dates deleted. I have seen false stories complete with fictional details as well.
I suspect that this was done to cover up more than I knew or know. Why would Kaiser go to this trouble to cover up something minor?
I have read the state statutes. This making of false entries is criminal in my state. The class ranges from misdemeanors to felonies.
A severely damaged patient is not able to file anything. Damage thoroughly enough, and there is no one to testify.
“Thrive”? Give us a break.
I am very disappointed with the doctors at Kaiser. I have allergies and the doctor would only give me over the counter drugs to relieve the symptoms. One of the doctors told me that it is their policy to prescribe OTC drugs unless their is none available for a given condition. Not only I have suffered between repeated visits to the doctors but also ended up spending large amount of money as copays simply because doctors do not want to do all needed tests to save money for KP. My allergies are getting worse. My visits to Kaiser were no better than going to longs drugs and consulting a phrmasist. I do not know what to do? Will they reimburse me if I see a non Kaiser doctor?
No, they will not reimburse you for seeing an outside doctor, unless: 1) you have Added Choice coverage; or 2) a Kaiser doctor refers you out (read: when hell freezes over).
If you want choices, and to have input into your own health care, your best bet is to change health plans.
I went to kaiser for sinus condition. The doctor said it was turbinates, he recommended i not have surgery unless it was intollerable. I just kept getting sinu infectins over and over. I called Kaiser and the ENT office wold not call me back. I called member services and i finally got a call. They said the doctor wold see me. I went thinking this was to discuss plans for surgery instead I arrived and had surgery. It was the worst pain in my life he said it would be not even as bad as a cavity. He only sprayed by nose with numbing spray. I could hear him breaking bones while he did the turbinoplasty. I asked why he could not put me to sleep and he said we dont do that for this procedure. I went home and googled it and found this surgery it done under General anesthesia, it is at least done with sedation and lidocaine. Why would be put me through this I am in so much pain 3 weeks later and he didint to even give me motrin or ANYTHING for pain
I’m sure all of the people reporting horror stories about Kaiser are true. There are pressures to contain costs, and cost-saving measures are not always taken in the most intelligent way.
Nations with socialized medecine, such as Britain, France, and Canada has similar constraints. As long as one is reasonably healthy (like me), one can get good enough medical care for free. But if something unusual comes along, the system doesn’t want to pay for it.
My question is this: Blue Shield raised my company’s premium 58 percent this year. I can’t afford to pay $1,098 per month for insurance with a $4,800 deductible and $5,900 out-of pocket maximum each for me and my wife. No other insurers have less costly plans, except for Kaiser, which would offer lower decuctibles for $400 per month less. What would you do? Go with Kaiser? Or dig into my savings to pay for “spare-no-expense” medecine?
Wow- I came here to get information before selecting a plan with one of the evil health providers…all I can say at this point is that WE are our own best advocates- because what else can you do when taking a leap of faith and trusting anyone, regardless of the service they perform- pilot, mechanic or doctor…
At the end of the day I am looking to find the group that is farthest away from the For Profit model whom are apparently OK with 50 plus % cost increases as their general approach. These bastards have been shown to both potentially kill you and leave you and your family penniless…if I am unfortunate enough to be a health care statistic at least I’ll have left my estate somewhat in tact.
Worse case scenarios are no-win situations.
Think I am going to go with KP and see for myself…the worse thing that can happen is that I see, thanks to sites like this, some clear warning signs and then bail out fast…
Thanks
Wayne
I personally do NOT care for Kaiser,Once my Doctor left Kaiser I was unable to choose my own Doctor and was passed to an internal medicine Doctor as my primary provider.
Basically to make a long story short I had a mammogram and ultrasound explained the issue with my breast and which one it was and where the problem was.
Female Doctor I had never met wanted to do biopsy which was fine problem was she wanted to stick me over 3 different times to numb my breast yet could not find the spot where the lump actually was AFTER I showed her numerous times my concern was not about the pain itself that I would endure but the fact that this Woman had no idea what she was doing so needless to say I told my Husband get me out of here NOW!!!!!
One of the best cases to seek out is found on you tube under “severe autism”. This family has been tortured by the kaiser system for years. Their son was first diagnosed when 2 at Kaiser. He’s been a kaiser memmber since 1991. It’s 2011, and they’re still tossing him around the fragmented system like Hitler’s boys tossed around people, to shift focus off their accountablity. Consequently, this boy has been denied adequate treatment for health damaging self abusvie behaviors for years due to the utter lack of quaily analysis and comprehensive care given to this autistic person. It has traumatized his mother, Imagine being told to “try this drug” for your autistic child who is beating himself in the head for days and “come back in a few months and we;ll see how that goes.” Kaiser has been doing this to the mom and kid for 18 years. He’s still hitting himself. Worse, when the mother finally had it. Finally blew up and said, this is wrong, you need to do deeper analysis like SPECT scans or something to really check out his brain so you stop “guessing” which drugs will work, the mom was told, “relax, just take one day at a time,” “eventually, we’ll find the right combination of drugs to help him.” Yea, sure. It’s been 18 years. Meanwhile, she and her family have to deal with the side effects from each casually prescribed drug that these doctors “think may help” time after time after time. It’s just one of the most disturbing long term neglect of an autistic patient that has ever been on record. Unbelievable neglicgenc and failure to provide effective treatment. one Kaiser doctor had the nerve to tell this mom, “why don’t you just take your son home and make him comfortable, his brain is messed up, that’s never going to change.” Nevermind this autistic adult has high potential to change, given he goes from days of slamming fists into head and having seizures, to days where he’s walking 6 miles and eating and drinking and making great eye contact, so clearly there’s a brain functioning issue invloved, and all kaiser is obsessed with doing with this patients is constantly giving him chest x rays, ct scans of head and mri structural brain images. NOT once have they taken the time to look at HOW his brain is functioning and fight the mom every time she asks for SPECT and provides them with evidence it could help better clinically evaluate her son and thus give doctors insight into proper treatment of drugs targetted to help areas of brain that a SPECT could show need to be stabilized or enhanced. Go to you tube. Type in “Autistic Adult in Crisis Goes Unnoticed”. Now this videos shows patient left in crisis after drug reaction at a kaiser contracted hospital. It wasn’t at kaiser. He was later transferred to kaiser where they kept him in 4 point restraints and let him hit himself and bust open his ears. WHile there, the mom was given the same song and dance and fragmented phones calls from drive by doctors who didn’t know or understand the patient and didn’t want to do SPECT and admitted they had to just “wait and see” if the latest drugs they’re now throwing at him, will work. Gee. I wonder how many morer years that will take. And how many more senseless beatings and suffering this poor family has to endure at the hands of kaiser. WHen mom said to kaiser doc she wasn’t getting good care for her son, the doc told her, “well you can always go somewhere else.” Gee, thanks doc, just what a mom in distress over her autistic son beating himself for years needs to hear. Thanks for the help. Get a hold of this mom and i’m sure she’d be part of a very strong class action suit. Tremendous evidence to sustain Kaiser is denying effetive treatment to autistic patients.
I love this site BECAUSE IT’S THE TRUTH! I’m stuck with Kaiser right now and let me assure all these doctors that feel like this site is over reacting, were not. I don’t know where to begin,
1 I’m always rushed
2 I can’t get a second opinion
3 Treatments are based on previous judgements
4 anyone working at Kaiser can view my health record (very disturbing)
5 I feel like i’m in Orwell’s 1984 when ever I go
6 Doctors are A#$H#$%s( prob. cause they know it’s a HMO), I’ve only met 1 doc that was cool.
If Kaiser was a dog It would have rabies,
How do I find an attorney with proven results and experience in arbitration?
For starters you can browse the Lawsuits category on this website and look for the names of attorneys who have won.
my story is long and complicated. short version, my mom was a nurse practioner for kaiser and my dad passed away under negligent kaiser care at the same facility she worked at. awkward?! yes, horrifying, absolutely. what i noticed wasnt mentioned on the board is the fact that most patients never even make it to an actual doctor. i’d like to know the actual percentage of the doctors patient load versus the P.A. or N.P. patient load. my mom was forced to take patients she had no business seeing, meaning the patient was not there to be seen for an issue in the spectrum of her expertice. yet doctors and others were constantly diverting cases to her because they refused to see patients the deemed unworthy of their time, and when she expressed her concern over the quality of care she was giving she was literally told, you carry the patient load and you see whomever we send to you, thats what your here for and if you have any concerns maybe you should seek employment elsewhere. fortunately i do not have kaiser, and after what happened to my father and the consistent failure of the entire facilities staff i would be scared to trust them, not to mention the insider info from my mother and others who spoke to her in confidence after my fathers death about who, what, and how our family was failed by kaiser providers.
It’s not true that Kaiser treat everything. I have been refused care for a wound on my face. Since they would not even SEE me they just diagnosed me over the phone (not exactly acceptable medical practice). It has been over 2 months since thehy refused to help me and in the meantime my skin has broken open and the skin seems to be disintegrating. An implant was pushed out of place in a bike collision and it slowly started to fall until now it is scarring, causing pain and infection but still Kaiser docs don’t like my standing up for myself and refuse to help. Kaiser gets $800 each month from the government. Can they do that legally. The 2nd doc told me to go the ER in another hospital and ask for a plastic surgeon but she refused antibiotics to me. Her feeling are hurt. God do we have to hold their hands too?
Kaiser not only sent me home with a blood pressure reading, 75/36 or 76/35. Nurse said I was one heartbeat from a coma…. I told tue dr. I thought I was having circulation problems because of m y pain and unusual painful bumps in my forearms and lower legs…. she said she did not know what I wanted her to do and swid there was nothing she could do for and sent me home….Not to mention being denied an insurance covered MRI….Until I argued for it, after being blamed for causing my own pain….The MRI showed a mass of scar t issue with lesions and se vere inflammationof my entire left region!….Oh the PAIN…The injury left me with residual pains
that has changed my life! !!!….! It goes on with horror…..