Since I believe strongly in the practice of patient advocacy, and believe in the moral wrongness of the managed care practice of medicine, I have founded a powerful new consulting service called "Second Opinion, Inc."
I am offering my medical services for the much needed second opinion that is lacking for the HMO patient. I will review a patient's medical history in the office or hospital setting, examine the patient, and formulate a problem list and treatment plan that conforms to the best standards of accepted American health care.
After the problem list is generated and a treatment plan is formulated, it is often necessary to convince the HMO that they will be opposed in their decision to ration care to this particular patient. At that time it may be necessary to formulate a medical demand letter, or coordinate efforts with an attorney to initiate a lawsuit on the patient's behalf.
I believe that an outside opinion is a much needed effort on the behalf of a patient, and may be most useful when that person is hospitalized under the HMO's care. I have seen such efforts make the difference between life and death.
I am delighted to provide medical-legal support when I can see that the patient is being wronged by the HMO.
A recent case I handled involved a woman who spent $140 in medical-legal consultation and after presenting a letter to the HMO she walked out of the HMO with a$60,000 check, with no attorney and owing me no part of it. I was very pleased that she got such a tidy sum to help with her household and medical needs. She had multiple fractures of the spine and had only been offered aceaminophen for three years by the HMO doctors! ! And they have such deep pockets from all the people that they take advantage of that they were happy to settle on the spot. Think about it: they kept it out of the courts and malpractice attorney's fees, out of state or federal regulators' scrutiny, and out of the state insurance regulator's hands. They told the lady "We have a para-legal department upstairs and if you would just follow us we will write you a check today. You don't even need an attorney."
Such is the state of our health care system. The health care attorney's now see the HMO's as the deep pockets of the future of medical litigation. I hope that my medical colleagues will begin to realized when their practices have become tainted or infected by the managed care bug, and realize that their form of practice will likely suffer if they do not de-enroll from managed care. I'll be waiting for them to re-enter the fold of principled medicine. And let someone call me a "provider"...
Copyright 1996 (all written materials, including "Second Opinion, Inc." and "principled medicine") by Donald J. Boles MD.