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Medical group accused of jeopardizing patients’ health

April 3, 2013

medA San Luis Obispo doctor has accused a medical group of “seriously jeopardizing the health, safety and lives” of patients by putting profits ahead of patient care. [Tribune]

John S. McGee filed a lawsuit against Heritage Provider Network claiming the group fired him last year for “his refusal to participate in an unlawful scheme to compromise patient care for profits.” McGee, who has practiced internal medicine for 20 years, was fired 19 months after going to work for the Heritage Provider Network.

Don Ernst, McGee’s attorney, told the Tribune he hopes the suit will compel the defendants to change the way they conduct business. In the county, about 20,000 people get their healthcare through the network.

The Heritage Provider Network issued a statement saying, “Heritage Provider Network is focused on providing quality, affordable, accessible healthcare to all its members throughout communities in California and has been nationally recognized for doing so.” The company does not comment on pending litigation.

 


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In my opinion, the American Medical Association should have take on the insurance mob a long time ago. Congrats to the Doc with huevos.


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There are all kinds of contracts between docs and insurance companies. I’m only surprised that we haven’t heard of more lawsuits of this kind.


Most docs simply play along…. there might even be some sort of bonus paid out at the end of the year if they’ve done a good enough job controlling costs. In some cases if a doc orders tests, it comes directly out of his reimbursement. He/she can actually make less money for trying to do too much!


http://en.wikipedia.org/wiki/Managed_care


The patients, unfortunately are often on the short end of the stick. It pays to know the fine print differences between HMO, PPO, Managed Care Plans, etc.


Good on Dr McGee for doing the right thing!


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Not yet, shelworth. There are still a LOT of people who are personally and emotionally invested in this issue. Showing them the realities of a government-run health care system this early on is not going to go over well. Many will have to actually experience it and have such things personally happen to them before they “see the light” as it were. To them, the labors of a doctor are their right to own (i.e. slavery).


Just ask them: What right do you have to a doctor’s labors?


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Good for Dr. McGee.


As patients, we grow frustrated with the “provider networks” jerking us around. What we often fail to realize is that these provider networks are also very likely jerking around the doctors and other professionals who belong to their network, which makes it just that more difficult for our physicians to provide us quality health care.


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What gives here? I thought that “putting profits ahead of patient care” was the sole purpose of America’s health care system!


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It would be interesting if Dr McGee would share more details. I have no doubt that Doctor McGee feels sincere in his claims. How often have we all watched our own doctors battle with our insurance companies for certain tests, etc that they believe are important and necessary? These networks are no different than the insurance companies in fact they’re insurance companies that provide medical care.


Insurance in this country isn’t what it used to be. We pay big $ for insurance and then when there is a loss, we hold our breaths wondering which fine print, clause or amendment they’ll cite in an effort to cheat us. Gone are the day’s of “breach of good faith” protection, and I know there was a big problem with fraud but it never seems to fail, when we give an inch, somebody takes a mile, be it our over rated/overpaid incompetent government or the large corporations.


.


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But of course, the solution of “Single Payer” cannot be mentioned in “polite” conversation because that would serve to remove the profit structure out from underneath the “for profit” insurance companies, and you know, we just cannot interfere with unbridled capitalism in any constructive manner that would serve to protect the masses, now can we?


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What right do you have to a doctor’s labors?


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Doctor attended public schools?


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The problem is that the middle-man is now running (and ruining) the show for the provider and end user. What was supposed to be a convenience is now a major problem. This and tort reform. Good luck getting insurance and tort reform from a bunch of lawyers on the take from the finance industry.


I have auto insurance, why doesn’t Geico pay for the gas in my tank, or my new tires and oil change?


Yet, we expect our health insurance to pay for checkups, exams, and minor issues. Great.


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