Tuesday, November 8, 2011

How is Kaiser Permanente in San Diego? Lawsuits and investigations

thepinksquid Moderator
Join Date: Jun 2007
Location: San Diego, California
How is Kaiser Permanente in San Diego?

Hello my knowledgeable City-Data friends...

How is Kaiser Permanente care in San Diego? I'm considering changing my health insurance to Kaiser Permanente next year, but I have to admit I'm a little apprehensive as I've never had anything like KP before.

The Kaiser plan I could get through my employer is extremely inexpensive and offers a health reimbursement account, so I'd essentially have no out of pocket costs other than my paycheck deduction (which is very low). Right now I have a Health Net HMO... and it's fine, but unfortunately my doctor is retiring so I have to choose a new one anyhow. I'd love a PPO but the one my employer offers is super $$$. I'm fortunate to not have any major medical issues and my yearly costs are pretty low.

Any thoughts? Are some San Diego Kaiser facilities better than other ones? I live close to the Zion and Vandever hospitals, but would gladly go further for better care. It seems some people LOVE Kaiser, and others love to complain about it.

Is there a reason it's so cheap? Is it better to spend the extra money not go with Kaiser? Thanks!

Moderator of San Diego, San Jose & San Francisco sub-forums. =]

Senior Member

Join Date: Oct 2008
Location: Eagle River, Alaska & San Diego, CA

Yes there is a reason. It is at times inferior health care. Kaiser is built on a platform of efficiency first not care. Hats off to the hard working people there but I have had several friends have recent horror stories this year.

As a clinician I would advise you to stay away. As a consumer I can say you get what you pay for.

...I hear this quite a bit also. If you are in good health, KP may be better for you. If you are sick, really ill or really injured in that event KP is last on my list. In addition, they traditionally have much poorer scores for acute inpatient care. The nice(ities) fall off when you are hospitalized. In addition, your access to key clinical doctors is limited by their system. As I said, I have had two friends this year alone who were misdiagnosed (one who did not have stage 4 lung cancer but instead an infection she got while caving hystoplasmosis) after months of telling people she was dying she finally saw another specialist outside the KP system. I also had good experiences with pediatrics for my children. If you get sick, really sick KP is the last place one wants to be IMHO.

Maura Larkins
To find out how Kaiser compares, go to US News and World Report hospital ranking:

I agree with AADAD that Kaiser is fine when you're healthy or when you have typical, though serious symptoms. You won't find Dr. House at Kaiser. They don't have the time to deal with any symptoms that aren't on their list of things to look for. They have a tendency to miss cancer diagnoses (both my friend and my mother were never seen by a Kaiser oncologist before their deaths from cancer). Most Kaiser facilities have outdated technology. (I see in the rankings in US News (see above) that the Medical Center on Sunset in Los Angeles is an exception.)

Kaiser Permanente Member Services is a joke. They cover-up serious problems. I recently complained that my X-rays taken on June 15, 2011 at the brand-new Garfield Specialty Center in Kearny Mesa were unavailable to my doctors. Member Services told me that the X-rays had not been saved electronically, but that the technician had saved a few X-rays on thermal paper and sent me some blurry photo-copied pages. Yet their advertising says all X-rays at Garfield Specialty Center are digitized! Are they lying to me or are they lying to everybody else???? I put my documents and X-rays on this webpage:

I complained to Member Services that the medical report about the X-rays was compromised. Kaiser's story was that the report had not been written by the urologist who had been present on June 15, 2011 and had seen the large series of X-rays as they were being taken, and spoken to me and examined me, but rather that the official report was written 5 days later by a non-urologist who had seen only 5 images on thermal paper! Also, the report had the wrong date of the procedure, the wrong referring doctor, and it was signed three days BEFORE it was supposedly written.

What did Member Services do with my complaint about tampering? They tampered with it! They changed it to say I was unhappy about not getting an anti-fungal medication--from a urologist! I did not want or need an anti-fungal medication; also, it is gynecologists or primary care doctors, not urologists, who deal with yeast infections. Kaiser can't even come up with a clever cover story.

Perhaps not surprisingly, the urology department in San Diego had lower than expected survival rates last year and average survival this year. About half of all hospitals have "better" or "much better" than expected survival rates.

Maura Larkins
Junior Member
Join Date: Nov 2011
Location: San Diego

They're playing the percentages. They take care of the simple cases.

(Originally Posted by earlyretirement)
Definitely I think you will find people that are happy with Kaiser and probably will find people that will complain as well. One thing I'll say is that for all of our visits with our doctors, someone from Kaiser followed up with a phone call the next day to see how everything went and even asked if we had any complaints. I've never had an health care insurance provider do something like that before. So definitely I do think they care about customer service and satisfaction.

They're playing the percentages. They take care of the simple cases--and almost all cases are simple. They want to please the majority of their patients. But they make a lot of profit, and they do it by cutting corners and denying care strategically. When they get taken to court, they say that the case was unusual, and they couldn't be expected to know what to do.

Making people happy does not make them healthy.

That pleasing the consumer is the trend now in health care to satisfy the consumer irrespective of solving the complex medical problems that they arrive with (on their own). From Scripps to Kaiser and Sharp to UCSD patient satisfaction scores are the goal. To make it worse, Medicare is linking payments to how well patients were "pleased" and satisfied. Nothing in my experience could be more undoing to the goal of sustaining a healthy person.

The steps to take now are to educate yourself and ask questions. Doctors and nurses are trained to solve problems related to our human bodies. We do better when we have a person who tells us about themselves. I cannot even begin to tell you the number of times the patient feeling satisfied gets directly in the way of helping them to be healthy down the road.

Kaiser is known for pleasing it's customer and in serious illness they would rather do that than solve the more complex problems. I concur on the cancer dx issues related in the post above. Kaiser puts it footmark on prevention. Once you are really sick, you would be better off in another hospital system. Stay alert to your bodies changes take notes do research and ask questions because in 5 years the nurse at your bedside will not be interested in asking key questions which would potentially save your life, they will be asking you how you want your coffee.


Not to resurrect a dead topic, but here's something that Huffington Post wrote about Kaiser's mental health services.

Kaiser Permanente Makes Billions In Profits While Overburdening Staff: Report

Maura Larkins
Location: San Diego

Why would this be a dead topic? This is fascinating, and seems to reveal that Kaiser is unrepentant about practices in the San Diego Psychiatry Department that led to a lawsuit and investigation in 2000:

Kaiser's Prescribing Policy Leads To Lawsuit, Ethics Concerns
Psychiatric News
May 5, 2000

One of the nation’s best-known HMOs has ignited a furor by requiring psychiatrists at one of its California facilities to write prescriptions for patients they have never seen.

Kaiser Permanente’s policy for psychiatrists in its San Diego area facilities stipulates that when they receive a request for a prescription for a patient that a staff psychologist, social worker, or family therapist is seeing, they are to comply with the request and write the prescription without scheduling a visit with the patient.

Widespread publicity about the policy, which was the focus of an April 13 Los Angeles Times article, has generated heated responses from psychiatrists and others concerned about how such a policy could seriously compromise patient care and put psychiatrists in ethical jeopardy.

The article revealed that a state agency was investigating this practice and that a psychiatrist who lost his job after refusing to follow the policy was suing Kaiser Permanente.

The day after the article appeared, APA issued a press release strongly condemning the policy as an example of "unethical" medical practice....

1 comment:

Anonymous said...

I just read template advice from a Kaiser physician of Japanese descent for a patient with orthopedic injuries not to drink milk. It vaguely mentiones "a Harvard Study" then goes into specifics about the products such as almond milk that one can buy at expensive stores. Seemed very odd. I mean, bully for your new-age Vegan preference, but just delivered to patients as medical fact? My own experience with Kaiser is horrible. I see them as little as possible because their insurance is so skimpy, they charge more than $200 (over my premiums) even for simple, once a year blood work.