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  • Report:  #751351

Complaint Review: RISK MANAGEMENT - PERMANENTE MEDICAL GROUP - OAKLAND CA - OAKLAND California

Reported By:
Gaston56 - Sacramento, California, United States of America
Submitted:
Updated:

RISK MANAGEMENT - PERMANENTE MEDICAL GROUP - OAKLAND CA
1 Kaiser Plaza OAKLAND, CA California, United States of America
Phone:
510-271-5910
Web:
Categories:
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Let me outline briefly how a set of circumstances, that comprised the most easily resolved medical  problem on the planet, has evolved into a tsunami of gigantic proportions.

Approximately three months ago, an elderly man (69 yr old former football player) who had been treated for a deteriorating skeletal condition for ten years, was assigned a  temporary replacement
Permanente physician, Dr. Susan Scholey, while his permanent physician, Dr. Gary Rinzler, took a few weeks to rest.

Dr. Scholey decided that, even though X-rays and ten years of ongoing evidence of success with this patient were present, they were insufficient.

Dr. Scholey therefore, placed an assessment requirement before the patient which was not part of the agreement the patient had with his permanent doctor, an assessment that Dr. Scholey could not defend in terms of either science or medical necessity.

Since  Dr. Scholey was theoretically in charge in Dr. Rinzler's absence, and since her recommendations to interrupt the ongoing treatment were not overturned by her immediate supervisors, Dr. Scholey terminated care of this elderly patient, including all medications.

Upon the return of Dr. Rinzler to the scene, he attempted to simply take back the patient and resume care. However, Drs Scholey, Midgley, Isaacs and Pearl evidently had decided that the independent assessment was necessary.

That being the case, the patient found the time resources to comply, since the assessment was now being recommended by Dr. Rinzler,  if only so that he could resume care. The patient therefore  underwent the assessment with Permanente physician,  Dr. Kegang Hu.

As the patient knew he would, Dr. Hu agreed wholeheartedly with Dr. Rinzler that the treatments being provided to the patient for ten years were appropriate.

However, when the patient then asked to be returned to Dr. Rinzler's care as agreed,  Dr. Scholey advised everyone that the matter had been referred to Permanente RISK MANAGEMENT, in Oakland, CA.

So, now we have a patient paying $5,000 in premiums, still only wanting to resume his decade long medical regimen, having complied with an unnecessary  assessment, still being denied the only medical services Kaiser Permanente was providing to him for this premiums.

Actions taken by the patient's Medical Representative thus far:

Medical Licenses of Drs. Scholey, Midgley, Isaacs and Pearl have been reported to the Medical Board of California. The Charge: Violation of the Elder Abuse Laws and Patient Abandonment.

Kaiser Permanent has been reported to the California Department of Managed Health Care for the same violations of law.

The patient himself has repeated constantly that the only thing  he requires is a return to the regimen that several physicians prior to Dr. Scholey felt was perfectly appropriate.

It is amazing all the staff time expended and agony generated when the resolution of this issue has always been so simple: Return the patient to the regimen that was in place prior to Dr. Susan Scholey deciding for non-medical, non-scientific reasons that an interruption was appropriate.

The patient has unilaterally indicated to anyone who will listen that he has backed away from a consideration of litigation, and simply and humbly continues to request that the simple treatment for his deteriorating skeletal condition be resumed under the direction of Dr. Gary Rinzler.

Not that it is particularly relevant, but to follow up on the football comment above. The condition was the result of a violent illegal back block during a football game that caused the compromised spinal condition initially. At that time, those kinds of hits were legal.

AGAIN THE SOLUTION IS SIMPLE: A  RETURN TO WHAT WAS THREE MONTHS AGO BEFORE DR. SUSAN SCHOLEY decided an elderly man didn't deserve to have his suffering ameliorated.

That the Permanente Medical Group has chosen to ignore this patient's  pain and legitimate need in the face of several evaluations which support the patient's long term regimen is testimony that, when an organization loses contact with the human aspects of medicine, all sorts of abuses are possible.

As of this writing, this elderly man, 69 years of age, is without medical services of any kind. He is currently paying Kaiser Permanente $5,000 in premiums for absolutely nothing.

Isn't there a word for that someone in America?


1 Updates & Rebuttals

James MK

La Jolla,
California,
USA
Down to cash

#2Consumer Comment

Thu, November 24, 2011

I get the strong impression that the dispute between physicians over this patient's care is motivated by financial rather than medical reasons, as evidenced by the matter being taken to Risk Management. The risk being "managed" is to the HMO's finances, not the patient's health. In such cases the solution is to make it clear to the HMO that not resuming proper care is likely to lead to greater financial loss than continuing treatment would. Unfortunately this has to be done through litigation (threat of lawsuit) and HMO's know very well that only the wealthy and the very poor (who qualify for legal aid) can afford to pursue this avenue with any chance of timely resolution.  

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