Wednesday, February 29, 2012

One Out Of Every Ten Wall Street Employees Is A Psychopath, Say Researchers

From what I understand, 4 per cent of all people are psychopaths, so the rate for investment bankers is about two-and-a-half times the normal rate. I imagine the rate for doctors is the normal rate, and the rate for insurance company employees is probably a bit higher than normal. But what about Kaiser Permanente, in which the insurance company and the doctors are inextricably linked?

One Out Of Every Ten Wall Street Employees Is A Psychopath, Say Researchers
The Huffington Post
By Alexander Eichler
02/28/12

Pictured: Christian Bale as Patrick Bateman, a Wall Street investment banker and psychopath. Researchers believe as many as 10 percent of people in the financial industry may exhibit the traits of clinical psychopathy.
Maybe Patrick Bateman wasn't such an outlier.

One out of every 10 Wall Street employees is likely a clinical psychopath, writes journalist Sherree DeCovny in an upcoming issue of the trade publication CFA Magazine (subscription required). In the general population the rate is closer to one percent.

"A financial psychopath can present as a perfect well-rounded job candidate, CEO, manager, co-worker, and team member because their destructive characteristics are practically invisible," writes DeCovny, who pulls together research from several psychologists for her story, which helpfully suggests that financial firms carefully screen out extreme psychopaths in hiring.

To be sure, typical psychopathic behavior runs the gamut. At the extreme end is Bateman, portrayed by Christian Bale, in the 2000 movie "American Psycho," as an investment banker who actually kills people and exhibits no remorse. When health professionals talk about "psychopaths," they have a broader range of behavior in mind.

A clinical psychopath is bright, gregarious and charming, writes DeCovny. He lies easily and often, and may have trouble feeling empathy for other people. He's probably also more willing to take dangerous risks -- either because he doesn't understand the consequences, or because he simply doesn't care.

An appetite for risk can seem like a positive business trait on Wall Street, where big gambles sometimes lead to big rewards. But for the people DeCovny is talking about, the outcomes matter less than the gambles themselves -- and the chemical rush of serotonin and endorphins that accompanies them.

This is hardly the first time that mental illness has been equated with a certain capacity for professional success -- especially in the financial sector, where some stock traders have actually scored higher than diagnosed psychopaths on tests that measure competitiveness and attraction to risk.


Some psychologists have long claimed that the qualities that make for a high-achieving politician or stockbroker are also the same traits that psychopaths have in abundance.

Other researchers generalize it to bosses as a species, saying that about 4 percent of all executives are psychopaths -- and that their relative lack of scruples is what helps them excel in business.

At the same time, the fast-moving, high-pressure environment of Wall Street probably compromises the mental health of some of its employees. A recent study found that many young bankers develop alcoholism, insomnia, eating disorders and other stress-related ailments within just a few years on the job.

Stockbrokers have also been shown to experience clinical depression at a rate more than three times as high as the general population.

DeCovny writes that for someone with a "latent" compulsive gambling problem, a job trading stocks can trigger pathological responses that send the person into an escalating pattern of lies, debts and even embezzlement and fraud...

Jacques Roy, Charged With $375 Million In Health Care Fraud, Gave Money To Tea Party

Jacques Roy, Charged With $375 Million In Health Care Fraud, Gave Money To Tea Party
Jeffrey Young
Huff Post
02/29/2012

If Texas physician Jacques Roy turns out to be guilty of charges he conspired to defraud Medicare and Medicaid of almost $375 million, we'll know where at least $1,650 of that money went: to a political action committee affiliated with the Tea Party Express, a group opposed to the health reform law that helped nab him.

Between August 2009 and January 2010, Roy wrote five checks to the Our Country Deserves Better PAC, associated with the Tea Party Express, according to Federal Election Commission records. Roy also gave $300 to the PAC for the Texas Medical Association, which opposed the health reforms enacted in March 2010 by President Barack Obama and Democrats in Congress. Those contributions also are listed in FEC records.

The White House partially credits new anti-fraud measures from the health care reform law with the case announced yesterday.

Roy, who lives in Rockwall, Texas, gave the money during the most contentious months of the congressional debate over national health reform. His first donation was in August 2009, when Tea Party activists and other opponents of the legislation stormed congressional town hall meetings and captured the attention of the news media. The Tea Party Express organized a bus tour and a rally in Washington to protest the health reform bill in August 2009.

According to federal law enforcement agencies, Roy's financial support of Tea Party causes also took place in the middle of his nearly six-year campaign to bilk government health programs. Federal agents arrested Roy and six others Tuesday alleging they worked together to file $350 million in bogus claims to Medicare and another $24 million to Medicaid. Louise LaMarre, who shares a home and business address with Roy, donated $710 to the Republican National Committee in 2008 and 2009, records show. LaMarre was not charged in the fraud case.

Spokespeople for the Tea Party Express, the Rockwall County TEA Party, the Dallas Tea Party, and the Rockwall County Republican Party did not respond to emails requesting comment.

The Department of Justice said Roy and his alleged conspirators charged taxpayers for home-health care services that were either unnecessary or never provided, in some cases giving patients cash, groceries and food stamps, in exchange for their cooperation. The indictment charges home-health agency representatives recruited patients door-to-door and at locations including a homeless shelter and a church in Dallas. Authorities said Roy had employees forge his signature on forms approving medical services.


Roy, a 54-year-old native of Canada, runs Medistat Group Associates in DeSoto, Texas, and worked with nearby home-health agencies to produce the allegedly false claims. The owners of three home-health agencies also were arrested Tuesday and, because of their connections to Roy, 78 other agencies had their payments cut off by the government agency that administers Medicare and Medicaid.

Roy signed off on services by more than 500 home-health agencies for 11,000 patients from January 2006 through November 2010 and "had more purported patients than any other medical practice in the United States," according to a Department of Justice press release.

Public records from the Texas Medical Board show Roy has been in hot water before. The board suspended his medical license for 30 days in 2001 and placed unspecified conditions on his practice until August 2005. The Dallas Morning News reported that the sanctions against Roy stemmed from a 2005 incident when he was an emergency room physician. According to the report, Roy provided "dozens of prescriptions" for painkillers to a woman with whom he was having an affair. The woman died in a car crash and an autopsy revealed high levels of the drugs in her system. Roy subsequently took a job caring for Dallas County jail inmates but was fired after six months, the newspaper reported.

Federal agents said they raided Roy's home and office last June and seized what they claim is evidence he created a fake identity and is a flight risk. An illegitimate Texas drivers license, a Quebec identification card, and a Canadian birth certificate all under the name Michel Poulin along with applications for a passport and Social Security benefits from Canada were also found. Authorities also found books entitled Hide Your A$$ets and Disappear, A Step-By-Step Guide to Vanishing Without a Trace and The Offshore Money Manual, according to the indictment.

Tuesday, February 28, 2012

Kaiser Sued For Failing To Pay Case Managers For Overtime

Sometimes I wonder if Kaiser Permanente has become so corrupt that honesty has ceased to be an option for Kaiser executives and administrators.

Kaiser Sued For Failing To Pay Case Managers For Overtime
Feb 28th, 2012
By Anneline Waldman
thejobmouse.com

A class action has been brought against Kaiser Foundation Health Plan, Inc., on behalf of all persons employed as “Senior Case Managers” in the State of California during the period that commences four years prior to the filing date of the complaint.

More specifically, the class includes “senior case managers” (Class A), “case managers” (Class B) and “Case Coordinators” (Class C) who are and were required to work without compensation, and to work over eight hours per day and/or forty hours per week without straight or overtime compensation, and to work without taking meal and/or rest break periods as required by law.

Plaintiffs Darryl Hold, Corissa Tittle-Bartolero and Ruby Haney brought this action on behalf all three which consists of current and former employees of Kaiser in the State of California who hold or held non-exempt positions as “Senior Case Managers”, “Case Managers” or “Case Coordinators” within four years prior to the filing of this complaint.

As stated in the complaint, Kaiser failed to pay the plaintiffs and the other members of Class A, Class B, and Class C one and a half times their regular rate of pay, or any other additional compensation at all, for the hours they have worked in excess of the maximum hours permissible by law, as required by the California Labor Code.

According to the complaint, reported by Courthouse News, the plaintiffs logged into and out of Kaiser’s timekeeping system each workday. However, they were instructed and/or encouraged by Kaiser to log in only for their scheduled hours each day, even if they had to spend more hours each day under Kaiser’s control in order to complete their work. They were also forced to work more than their scheduled number of hours, because they were delayed in completing their work pending approvals from upper level management.

Due to the work load and mandatory delays, plaintiffs regularly begun work before they logged in and/or regularly continued working after they had logged out. They also regularly had their time adjusted down by Kaiser. Thus, they were required to work “off the clock” to complete their job duties...

Monday, February 27, 2012

Kaiser belatedly announces new Executive Medical Director/CEO for SCPMG


Edward Ellison, SCPMG CEO/Executive Medical Director

Apparently Kaiser Permanente has been keeping a secret from the public since January 1, 2012 when its Southern California Permanente Medical Group CEO, Jeffrey Weisz M.D., left for Oregon.

Kaiser kept mum about who would replace Dr. Weisz.

UCLA was apparently the first to release the name of Edward Ellison, referring to him as the "Medical Director Elect" on January 25, 2012, when Dr. Ellison spoke at the "The Health Forum" at UCLA. If Dr. Ellison was the "Medical Director Elect" on January 25, 2012, then why does Kaiser indicate in the article below that he assumed his job on January 1, 2012? If you look closely, you will notice that Kaiser was a bit cagey about the announcement. It says Dr. Ellison "assumed the role" of medical director. Does that mean he was really an acting director on probation? It certainly appears that there is some question as to when he became official.

Today I found that Kaiser had slipped an announcement (below) unobtrusively into its website, without any press release. It shows a date of 2/22/2012. I searched the Internet diligently on 2/24/2012, but I could not find any announcement until 2/27/2012 when I got a Google alert. I expect that the announcement will eventually start to appear in Google search results, but at this time anyone who does an Internet search will probably conclude that Jeffrey Weisz is still Medical Director.


From Kaiser Permanente website:
Executive medical director/chairman of the board
Edward Ellison, MD
Southern California Permanente Medical Group

Edward Ellison, MD, assumed the role of executive medical director and chairman of the board for the Southern California Permanente Medical Group on Jan.1, 2012. The Southern California Permanente Medical Group is one of the largest self-governing medical groups in the country, consisting of more than 6,000 physicians caring for nearly 3.3 million Kaiser Permanente members in 190 medical offices and 13 hospitals across Southern California.

Prior to this role, Dr. Ellison was the area medical director for Orange County, leading more than 600 physicians in caring for 430,000 members in two hospitals and 19 medical offices. His tenure in Orange County was marked by high performance, expansive growth and a strong culture of innovation and collaboration. Under his leadership, Orange County won multiple awards for patient safety, community service and excellence in patient care.

Dr. Ellison joined SCPMG in 1984. He has served the group in multiple roles, including president of the professional staff, chief of staff, physician director of the Performance Improvement Committee, physician director Primary Care Services, and assistant area medical director. Dr. Ellison has been a member of SCPMG’s board of directors since 2002 and is a past member of the Orange County Medical Association’s Board of Directors and the California Medical Association House of Delegates. He is a past recipient of Orange County's Family Medicine Physician of the Year.

After completing his undergraduate degree at Duke University, Dr. Ellison received his medical degree from the University of Virginia. He completed his residency training in family medicine at Halifax Hospital Medical Center, University of South Florida, where he served as chief resident. He is board certified in family medicine and is a diplomat of the American Academy of Family Physicians. He has attended the Advanced Leadership Program at the University of North Carolina at Chapel Hill and Harvard’s Advanced Management Program.--2/22/2012

Two black eyes? Kaiser and Komen Foundation

Kaiser and Komen

In a ghastly coincidence, the same day Komen pulled the money from Planned Parenthood because Stearns thought they were spending federal funds on abortions, the Journal of the America Medical Association published a damning study that almost half of women receiving second surgeries after lumpectomies didn't need the procedure. Painful, disfiguring, unnecessary surgery. At least three of the four sites studied in the JAMA report -- the University of Vermont, Kaiser Permanente Colorado, and the Marshfield Clinic -- has a relationship with the Komen Foundation. Kaiser Permanente is a "corporate campaign partner," the University of Vermont received a research grant, the Central Wisconsin Komen affiliate sponsors programs at the Marshfield Clinic. Maybe Komen should concentrate their granting criteria on whether the recipients are actually helping cancer patients.


The Komen Foundation's Black Eye
Linda Hirshman
The Atlantic
FEB 1 2012

By no longer donating to organizations "under investigation" by any federal, state, or local government, the Susan G. Komen Foundation is replacing its pink ribbons with a black list.

Recently, the Susan G. Komen Foundation, whose ubiquitous pink ribbon symbolizes its mission of curing breast cancer, adopted a mysterious rule. They would no longer make bequests for any services to any organization that was "under investigation" by any branch of any federal, state, or local government. Of course Komen is completely free to do whatever it likes. But recent American history contains a powerful warning against letting random legislators determine who gets cut off by their funders. Years ago, when Hollywood screenwriters invoked their constitutional right not to incriminate themselves in front of the red-hunting House Un-American Activities Committee, the private members of the Motion Picture Association put them on a blacklist, never to be employed again. In the years since the McCarthy fever abated, the blacklisting episode has come to be a symbol of political cowardice and wrongdoing. Komen does itself a disservice by replacing the pink ribbon with a black list.

Had anyone been looking, they might have asked why the cancer foundation needed such a rule. After all, how likely is it that a research university or cancer screening provider would attract the attention of the protectors of the public weal? Just before Komen passed its new rule, a passionately anti-abortion Republican congressman, Cliff Stearns, had announced he would be investigating the nationwide cancer-screening service provider Planned Parenthood. Not anything to do with cancer screening of course, but because Americans United for Life had told Rep. Stearns that they suspected the longtime contraceptive pioneer of using some of its federal funding for abortions. And yesterday, Komen pulled the million dollars it gives Planned Parenthood annually for cancer screening. After all, rules are rules.
What if the IRS was looking into a hospital's tax status? Would Komen have to pull their funding too?

Skeptical commentators are speculating that Komen bowed to political pressure. As conservatives increasingly targeted Planned Parenthood in recent months, various organizations explicitly upped the ante with Komen over their support of the non-profit. The Southern Baptists pulled their Pink Bible program, which produced a dollar for Komen with every Bible sold. Last April, Komen hired as vice president for public policy Karen Handel, a failed Republican candidate with a long online history of hostility to Planned Parenthood and contraception in general. And then it enacted its new rule.

The skepticism is further fueled by the weirdness of a rule letting any city council member or random state legislator decide to defund a Komen grantee just by starting an "investigation."...

Many "mistakes" found in newbie-doctors' resumes

Many "mistakes" found in newbie-doctors' resumes
By Kerry Grens
Feb 21, 2012
(Reuters Health)

Honesty and attention to detail are qualities expected of physicians, yet two studies looking at applications to training programs in obstetrics show that up to 30 out of every 100 applicants took credit for research publications that could not be found.

"Our hope is that these are honest mistakes and not willful attempts to mislead," said Dr. Michael Frumovitz, a professor at the University of Texas MD Anderson Cancer Center in Houston, and lead author of one of the studies.

In a field where precision is important, "even if it's an honest mistake it's very troubling," he said.

Earlier studies have found that other specialties within medicine suffer from the same problem.

Anywhere from one to 30 percent of applications to training programs in radiology, emergency medicine, orthopedics and others include references to published research that can't be located by reviewers.

Frumovitz and his colleagues and a separate group at the University of Washington, who published their reports in Obstetrics & Gynecology, wanted to find out if the same was true in their fields.

The team led by Frumovitz collected all 258 applications to a fellowship program at MD Anderson in gynecologic oncology from 2004 to 2008.

The applicants were doctors who had completed their medical school and residency training.

Of the 148 doctors who listed that they had published research findings, 44 included a reference to a publication that Frumovitz's group could not track down.

"We all believe that applicants have the best intention and are representing themselves truthfully. But (this result) falls right in line with others who have done similar work," said Frumovitz.

The University of Washington team, led by Dr. Anne-Marie Amies Oelschlager, looked through two years' worth of applications to a residency program in obstetrics and gynecology.

Residents are doctors who have finished medical school, and are continuing their required clinical training in a particular field.

Among the 937 applicants, 357 put down that they had at least one research study that was published or about to be published in a peer-reviewed outlet.

When Amies Oelschlager's group went to find those publications, 156 of the 1,000 publications listed turned up missing.

They looked online, in publication databases and even contacted the journal for verification.

Of the other publications that were confirmed, the researchers found inaccuracies there as well.

The biggest error was that 62 applicants had listed a publication as "peer-reviewed" when it wasn't.

Peer review involves submitting a study for scrutiny by other researchers before it gets published, and therefore implies a high degree of rigor.

Amies Oelschlager said her study could not tell whether these were honest mistakes or intentional misrepresentations.

"The best you can assume is that these applicants didn't look up what peer review meant or they don't understand it," she told Reuters Health. "None of that is flattering and you worry whether they really understand the tenets of authorship, research, what is peer review and what is not."

Residencies and fellowships are competitive, and research experience is looked upon favorably when applicants are being reviewed.

"Applicants might be deliberately padding their resumes to try and get a spot, and it's concerning. The whole thing about being a physician is that you are expected to be honest," Amies Oelschlager said.

Dr. Lee Learman, a professor of obstetrics and gynecology at Indiana University School of Medicine, said that it's not clear whether errors on applications relate to errors in medical practice, but it is of concern.

He said that medical students and residents should be aware that misrepresenting their work could have negative consequences on their careers.

"Even though we don't know how this predicts future infractions, most directors of residencies and fellowships don't want to take the risk," Learman told Reuters Health. "They might say, this person might misrepresent data about a patient or misrepresent a step they took during surgery."

Learman encouraged directors of residency and fellowship programs to check the accuracy of applications, and if they can't find the publications listed, to ask the person to produce a copy.

Frumovitz said one way to make sure publication lists are accurate is to require that applicants include a copy of the paper or an identification number that will make it easier to look up.

Amies Oelschlager and her colleagues suggested that medical schools should include training in authorship and peer review.

Friday, February 24, 2012

Dr. Jeffrey Weisz' sudden and mysterious departure from Southern California Permanente Medical Group

UPDATE FEB. 27, 2012:
On February 27, 2012 Kaiser Permanente's announcement of its new CEO/Executive Medical Director for Southern California, Edward Ellison, finally popped up on the Internet. The announcement is low key, and is NOT among Kaiser's press releases.


Jeffrey A. Weisz, MD
Executive Medical Director and Chariman of the Board 2004-2012
Southern California Permanente Medical Group

It would appear that Executive Medical Director Dr. Jeffrey Weisz' departure from SCPMG in January 2012 was precipitous and unplanned, since he's been gone for almost two months and no replacement has been announced. I couldn't get anyone to answer the phone at SCPMG headquarters in Pasadena to explain what's going on. Dr. Weisz went to Northwest Permanente Medical Group. Kaiser executives seem to spend only a short time in each position, perhaps to escape responsibility for problems.

Dr. Jeffrey Weisz Has Big Plans for Kaiser Permanente
By: Diane Lund-Muzikant
The Lund Report
February 22, 2012

Dr. Jeffrey Weisz is a man on a mission. As the newly appointed president and executive medical director for the Northwest Permanente Medical Group, he’s setting his sights high.

“I believe Kaiser is the answer to healthcare in America, and I’m going to prove it,” he said in a candid interview with The Lund Report. “We’re going to save more lives, and out perform everyone with better service and access, and have the best price and the best quality. Insurance companies that have the best rates win the market. But, I want the best rate and the best quality.”

Competitors such as Providence want Kaiser’s 500,000 members, he said. “But they’re not getting them. We have a better chance they’ll lose them to us because I’m very laser focused on what needs to be done. I want to take over the market and make Kaiser as big as I can, and would like to add 20-25,000 new members every year.”

Weisz intends to partner with private employers interested in lowering their healthcare costs and having a healthier work force.

“We can run a report that no one else can, and tell employers how many of their employees smoke, how many are overweight, how many of people with diabetes have their blood sugar out of control,” he said. “No one else can do this. Everyone’s looking for an answer on how to lower healthcare costs that are escalating every year. If you prevent illness and have higher quality, you’re going to lower your costs and save lives. That’s what I believe in and what I’ll help bring to the northwest region.”

Weisz has other changes in mind as well since joining Kaiser on January 1...


Kaiser Permanente Physicians Choose Medical Director
By: The Lund Report
August 2, 2011

The board of directors of Northwest Permanente, the physicians group that provides medical care to Kaiser Permanente members, has named Dr. Jeffrey A. Weisz as president and executive medical director.

He comes to the Northwest from Kaiser Permanente’s Southern California Region, where he was chairman of the board and executive medical director of the Southern California Permanente Medical Group (SCPMG). With more than 6,000 physicians, SCPMG provides care to 3.3 million members.

During his seven years leading the group, Kaiser Permanente Southern California earned numerous national clinical and service quality awards for breast cancer and colon cancer screening, hypertension control, fracture reduction in women and more.

"I am excited about the opportunity to lead Northwest Permanente’s outstanding group of physicians during this challenging time for health care in this country," said Weisz. "We’re not going to change healthcare in America until we change the health of America. As a health organization committed to prevention, no one is better equipped to tackle this challenge than Kaiser Permanente."

In his role as leader of the Northwest Permanente medical group, Weisz will oversee 1,100 physicians and focus the organization’s efforts on quality and performance. He will also partner with Kaiser Foundation Hospitals and Health Plan to provide members with high-quality care that is affordable, personal, and accessible. He’ll also be closely involved in the opening of the new Kaiser Permanente Westside Medical Center in Hillsboro, set to open in 2013, as well as the implementation of healthcare reform policies.

Weisz began his career with Kaiser Permanente Southern California in 1978 as a staff hematologist/oncologist at Panorama City Medical Center. He also served as an area medical director of Woodland Hills Medical Center prior to his tenure as SCPMG’s board chairman and executive medical director.

Weisz is board certified in oncology and internal medicine. He received his medical degree from Wayne State University School of Medicine in Detroit and completed his residency at Henry Ford Hospital in Detroit and a fellowship in clinical hematology/oncology at LA County-USC Medical Center.

Thursday, February 23, 2012

Alcoholism not uncommon among surgeons

Alcoholism not uncommon among surgeons
By Kerry Grens
Feb 22, 2012

(Reuters Health) - About 15 percent of surgeons have alcohol abuse or dependency problems, a rate that is somewhat higher than the rest of the population, according to a new survey.

The researchers also found that surgeons who showed signs of alcoholism were 45 percent more likely to admit that they had a major medical error in the past three months.

"Surgery is a stressful business. There are people who turn to alcohol to help deal with their stress," said Dr. Edward Livingston, a professor at the University of Texas Southwestern Medical Center, who was not involved in the study.

"Does that affect their performance? Who knows?" he said.

The researchers, led by Dr. Michael Oreskovich at the University of Washington, sent out a survey to more than 25,000 surgeons.

The questions asked about work, lifestyle and mood, and several were used to screen for alcohol abuse or dependency.

Overall, 15 percent of surgeons showed signs of alcohol problems. Other studies have estimated that, among the general population, the number is about nine percent.

The study did not determine why alcohol problems might be more common among surgeons.

Oreskovich's results showed that alcohol problems were linked with the doctors reporting depression and burnout as well.

Even within the various fields of medicine, surgery is considered particularly demanding.

"The nature of the beast is that the percent of emergencies, the percent of after hours work, and actual scheduled work itself all require an energy and concentration that is really different than a lot of the other specialties," Oreskovich said.

About 14 percent of male surgeons and 25 percent of female surgeons showed signs of alcohol problems.

The study could not explain why women appear to be more at risk of alcoholism in this group.

"Observations from previous studies show that the stress of being a surgeon, and balancing professional and personal obligations, is much more prevalent in female than male surgeons," Oreskovich told Reuters Health.

ERRORS, ALCOHOL LINKED?

Among the 722 physicians who said they had a major medical error in the past three months, 77 percent of them scored within the range of having alcohol problems.

These results "show there's a big problem and that we need to do something about it, especially for the patients but also for the physicians' health and well being," Oreskovich said.

"Obviously, this is a signal for further study," he added.

One of the limitations of the survey is that only about 7,200 surgeons out of the 25,000 queried responded to the survey.

In an editorial accompanying the report in the Archives of Surgery, Livingston points out that this is a very low response rate.

"If you have a low response rate, you don't know if it represents the universe of people you're trying to study," he told Reuters Health.

Oreskovich said it's possible that the percent of surgeons with alcoholism is underestimated in this study, "because I think the folks who are less likely to respond may have shame and guilt and fear associated with their alcohol abuse and dependence that they don't want to report on the survey."

He said that other studies of physicians who go into rehabilitation show very low relapse rates back into substance abuse.

Sunday, February 19, 2012

Anna Rahm v. Kaiser: Kaiser refused to give an MRI for three months; aggressive cancer then found

Shamefully, the California Medical Association, California Hospital Association and California Dental Association supported Kaiser's denial of care to this patient. The Court of Appeal ruled on behalf of the patient.

Filed 2/15/12 CERTIFIED FOR PUBLICATION
IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA. SECOND APPELLATE DISTRICT

KAISER FOUNDATION HEALTH
PLAN, INC., et al.,
Petitioners,

v.

THE SUPERIOR COURT OF LOS
ANGELES COUNTY,
Respondent.

ANNA RAHM et al., Real Parties in
Interest.

...Anna Rahm is a member of the Kaiser Permanente Traditional Plan (the plan),
which provides its members medically necessary health care in exchange for monthly
premiums. In August of 2008, Anna began experiencing back pain. Anna‟s parents,
Lynnette and James Rahm, took Anna to a chiropractor. After the treatments failed to
alleviate Anna‟s pain, the chiropractor recommended that Anna “consult with a medical
doctor because she was in need of an MRI.”

In March of 2009, Anna met with Charlene Huang, a primary care physician at
Kaiser. Lynnette accompanied Anna to the appointment and requested that her daughter
receive an MRI. Although Huang acknowledged that Anna‟s chiropractor had
determined that her back pain was “„severe,‟” Huang refused to order an MRI. Huang
referred Anna “to the physical medicine department at [Kaiser] and also prescribed pain medications and steroids, a much less expensive treatment than an MRI. . . .” Anna took the prescribed medications but her pain persisted.

Two weeks later, on March 24, 2009, Anna met with Ngan Vuong, a physical
medicine doctor at Kaiser. Lynnette accompanied Anna to the appointment and again
requested that Anna receive an MRI. Vuong, however, recommended that Anna receive
an epidural and suggested that her pain could be remedied through changes to her
nutrition and exercise habits. Lynnette told Vuong she did not want her daughter to
receive an epidural and renewed her request for an MRI. Voung refused to authorize an
MRI.


This factual summary is based on allegations in plaintiffs‟ complaint, which we
assume to be true for the purposes of reviewing the trial court‟s order denying
defendants‟ motion to strike. (See Turman v. Turning Point of Central California, Inc. (2010) 191 Cal.App.4th 53, 63 (Turman) [“„In passing on the correctness of a ruling on a motion to strike [punitive damages allegations], judges read allegations of a pleading subject to a motion to strike as a whole, all parts in their context, and assume their truth.‟

In April of 2009, Anna sought acupuncture treatment for her pain. The treatments
were unsuccessful annd the acupuncturist recommended that Anna request an MRI from
her doctor. Lynnette called Vuong and informed her that Anna‟s acupuncturist had
recommended an MRI. Vuong again declined an MRI and referred Anna to Kaiser‟s
physical therapy department.

In May and June of 2009, Anna continued her acupuncture treatments. Two
different acupuncturists concluded that Anna was in need of an MRI. Anna also attended several physical therapy sessions at Kaiser, but was forced to discontinue the treatments because they were too painful. Kaiser‟s physical therapy department “recommended that [Anna] receive an MRI.”

Lynette called Vuong again and explained that a chiropractor, two acupuncturists
and Kaiser‟s physical therapy department had all recommended an MRI. Vuong rejected
these recommendations because they were not made by medical doctors, but invited the
Rahms to seek a second opinion.

Lynnette elected to schedule a meeting with another doctor. Prior to the
appointment, Lynnette contacted Huang, Anna‟s primary care physician, “as a last ditch effort” to get an MRI. Lynnette summarized the treatments Anna had undergone since her initial visit with Huang. Huang finally agreed to authorize an MRI, which was performed on July 2, 2009.

Anna‟s MRI indicated that she had an “aggressive mass” in her pelvis. A biopsy
revealed that Anna was suffering from a “high grade” osteosarcoma, which is “one of the fastest growing types of osteosarcoma, meaning that [Kaiser‟s] three month delay in ordering [Anna‟s] MRI allowed the cancer to spread and ultimately substantially
contributed to [Anna‟s ] poor prognosis.” Anna underwent chemotherapy and had
numerous surgeries that resulted in the loss of her right leg and portions of her pelvis and spine...

Monday, February 13, 2012

Kaiser abused emergency patient, thinking he was not a Kaiser member, then quickly cleaned up evidence when his wife produced his Kaiser card

Kaiser Patient Alleges Severe Mistreatment
By WILLIAM DOTINGA
Courthouse News Service
February 10, 2012

LOS ANGELES (CN) - Kaiser Hospital kept a longtime patient suffering from
stroke-like symptoms in a storage room, lying in his own excrement, and abused him,
the man claims in Superior Court.

Kaiser personnel at the Baldwin Park facility allegedly believed David Stanley was
"homeless" and "a drug addict looking to 'score' drugs."

The suit names as defendants the Kaiser Foundation Health Plan; its contractor,,
Securitas Security Services of America; and Dr. David Kim.

Stanley says that he had regularly been treated by Kaiser for medical conditions,
including diabetes, after his stroke in December 2010. After waking to find that he
could not move his legs on Feb. 2, 2011, he took an ambulance to Baldwin Park,
according to the complaint.
But Kaiser employees allegedly told Stanley that "they could not find his name 'in
their system'" and refused to believe the patient's claims that his wife would soon
arrive with his Kaiser membership card.
"On a number of occasions, employees of Kaiser [including a doctor, later
identified as defendant Kim] told plaintiff he was lying and that 'there was no one out
there for him,'" the complaint states (brackets in original).
Refusing to treat him, Kaiser employees allegedly left Stanley on a gurney in the
hallway. He "heard various Kaiser employees [both to his face and amongst
themselves] question his legitimacy as a patient and also complain that they were
being made late for their scheduled break," according to his complaint (brackets in
original).
"At one point, the emergency personnel who had transported plaintiff to the facility
and who had remained were accused of 'dumping' a homeless man at the facility
and were asked 'where did you find this guy,'" the complaint continues. "Emergency
personnel told Kaiser employees they had picked Stanley up at his home and that
he was not 'homeless.' At one point, the emergency personnel were told to 'get this
guy out of here' and take him to another hospital."
Kaiser personnel, including Dr. Kim, allegedly accused Stanley of inventing his
symptoms to secure drugs. Stanley "heard Kaiser personnel accuse him of being a
drug addict and claiming that his 'alleged symptoms' were the result of him 'detoxing'
and that they 'saw it all the time,'" according to his complaint.
Stanley continued to insist he was a legitimate patient and begged for hospital
staff to look for his wife in the waiting area. He says they responded by pushing his
gurney "around a corner away from the Kaiser personnel."
"While waiting to be treated, plaintiff began to experience extreme gastric distress
and believed he would soon lose control of his bowels," the complaint states.
"Plaintiff repeatedly requested that he be helped to the bathroom or that he be given
a bedpan so that he would not soil himself. His requests were ignored and eventually
plaintiff lost control of his bowels and soiled himself. Thereafter, plaintiff repeatedly
requested that he be cleaned up. Again, his requests were ignored (one nurse
stated, 'don't worry about it') and he was left sitting in a hallway, in full view of others."
"While waiting for someone at Kaiser to show him any care or kindness
whatsoever, plaintiff heard numerous Kaiser employees accuse him of being,
amongst other things, homeless, a drug addict looking to 'score' drugs and a liar,"
the complaint states. "Eventually, understandably frustrated, plaintiff began to raise
his voice, insisting that he be treated. Kim told him that, unless he 'shut up,' security
and/or the police would be called and plaintiff would be forcibly removed from the
facility. In one exchange, after plaintiff grew more frustrated, a nurse told plaintiff,
'you can lay there in your own shit.'"
Staffers eventually moved Stanley to an examination room that was being used to
store supplies, he says. But Kaiser employees allegedly refused to treat him or clean
him. He was "left alone in the room, covered in his own excrement," he says.
Deciding to get up and find his wife, Stanley allegedly began yelling for Kaiser
personnel to help him.
"As he began to stand, supporting himself with a chair, Kim entered the room
followed by 2-3 guards and 2 nurses," the complaint states. "One of the guards
[named co-defendant John Gonzalez] yelled, 'he's gonna charge' and immediately
rushed plaintiff and tackled him, driving plaintiff into the wall and kneeing plaintiff in
the midsection. Plaintiff's head struck the wall and his arm was scraped as he fell to
the floor, with Gonzalez on top of him. Kim yelled 'get off of him,' but once plaintiff
was on the floor, Gonzalez continued to hit and kick plaintiff, who was defenseless.
Thereafter, someone yelled 'get up,' plaintiff indicated that he could not get up and
that he was injured. Plaintiff's injuries were significant enough to leave blood on the
wall and floor."
Stanley says that Kaiser employees then told him to stay where he was. They left
him "lying on the floor, covered with his own excrement and now bloodied," the
complaint says.
An orderly was charged with watching Stanley, but no one attended to his wounds
or treated him, Stanley says.
After persuading the orderly to find Stanley's wife in the waiting room, the worker
allegedly returned in minutes with Stanley's wife and his Kaiser identification card.
"The attitude of the Kaiser employees instantly changed," Stanley says. He was
"immediately taken to another area, where he was cleaned and was given treatment
for his complaints ... [and] provided with a bedpan and hot towels."
"Employees of Kaiser also immediately began to clean the area where plaintiff had
been assaulted, attempting to clean up all evidence of excrement and blood from the
floor and walls," Stanley alleges...