1. The Permanente Medical Group is for profit each share in Northern California being worth $10,000; quick home loans through Kaiser companies help enhance the benefits of minimizing care;
2. The physicians are told in the Permanente Journal to get involved in politics and medical societies to promote the Permanente Promise, not really to advance general medicine itself;
3. Collaborative team care is being substituted for physician care to save money and keep the stock value for physicians rising at about 18% a year;
4. Dr. Lawrence’s new salary as of the year 2000 was over $2 million a year, not counting all of his corporate duties within Kaiser contractors and alliances – PGE, Caretouch, Raffles Medical Group, pharmaceutical companies, etc. (the salary source is their own 990 IRS reporting form);
5. The methodology of patient terrorism in Kaiser is buried in arbitrations as Kaiser fends off class action legal suits at every turn – in San Francisco, in Seattle, etc.;
6. Under “Patient Rights,” Kaiser cannot even follow their own guidelines posted on their own walls, e.g. patients in phone appeal hearings do not even know who is in the room making decisions;
7. Specific Kaiser deaths include lung cancer called shoulder bursitis, preeclampsia called migraine, pediatric quadriplegia due to failure to recognize standard definitions of high risk pregnancy, angina treated with antacids, absence of a physical in nine years of care, chronic potassium overdose with induced infection, stomach cancer seen on x-ray with followup not timely, dissecting aortic aneurysm treated by non-urgent ambulance, etc. [I’m ready on all of these];
8. Kaiser has empowered nurses to initiate medications, prescribe insulin doses, biopsy colon polyps, etc. as a substitute for physician expertise;
9. Kaiser is the only HMO in the country involved in massive pill splitting – now some 37 varieties with physicians encouraged to use these pills over others – the organization has probably pocketed $200 million on this shabby behavior alone;
10. Kaiser’s $100 million a year ad campaign has bought the media silence they need to carry on; but only California really tolerates Kaiser big time – hence the term “Kaiser-fornia”;
11. Kaiser’s national “Anthrax Guidelines” (really a physician recruiting gimmick) do not coincide with those of the CDC; most likely the Kaiser approach will be found in the courts to have contributed substantially to the deaths of the two postal workers near Washington DC.
12. Kaiser’s “group ethic” gives permission for taking care away from the elderly to perhaps redistribute it to others; if Kaiser can use the money for business investments, so be it;
13. Kaiser’s unique right – one of a handful of such corporations in California – to keep its own injured employees dependent on Kaiser care for a full year (rather than the standard of one month) makes every employee a potential slave of the giant HMO;
14. Kaiser is the only HMO in the country that feels that its “Best Practices” of “Evidenced Based Medicine” are so riddled with care rationing that they need to be password protected even from other physicians outside the organization;
15. Kaiser tries to change the profession of medicine into the business of mangled care, for example, placing on break room walls such advice as that the answer to feeling understaffed is to realize that Kaiser is a “mean machine”; after all as Kaiser pamphlets remind us, patients are only “external customers.”
Kaiser succeeded with Dr. Lawrence’s “Path to Recovery 2001 Plan” – with the state and federal government asleep at the regulatory wheel. More nurses; fewer docs. More pills; lower doses. More stress tests; far lower percentage read positive. Fewer C-sections; more infants with paralyzed arms. Yes, and even janitors answering emergency room buzzers as patients try to get help. Not a very pretty picture. But hey, someone has to drive a Porsche.
Allowed by Sacramento to carry on this way unchecked, Kaiser pulls down the medical neighborhood throughout the state. Political kickbacks funded by the Kaiser “nonprofit” (house for every administrator) Plan through the Permanente Medical Group (bonus if you’re bad) and on to the Governor seal the deal. The DMHC has no choice but to allow the gorilla of greed safe passage.
Chuck Phillips, MD
Former Kaiser physician