Bette Robin, DDS, JD 877 DrRobin
SELECT PRACTICE SERVICES, INC. / DENTAL PRACTICE SALES
SELECT PRACTICE SERVICES, INC. / DENTAL PRACTICE SALES
THE BUCK STOPS HERE
How far do we dentists have to go to economically please dental
groups providing treatment via health maintenance organizations? Our
San Diego medical colleagues recently struggled with this question in a
widely publicized case involving the termination of a physician from a
medical group because he failed to compromise his quality of care.
San Diego superior court decided we don’t have to go too far!
The jury awarded the physician 2.5 million dollars for his wrongful
termination. This physician, whose name was not released, is a dual
board certified doctor in both pediatrics and gastroenterology. He
worked for the defendant medical group for over 12 years and this
group provided the majority of physician staffing at the Kearny Mesa
hospital in which the physician worked. The doctor claimed that the
medical group demanded he compromise his quality of care to patients
to provide the group with a better economic return. He specifically
claimed that he was required to spend less time with patients, was
urged to forego diagnostic tests, and was constantly pressured to
perform expensive, revenue generating, invasive procedures. Further,
the physician claimed that the hospital was chronically understaffed
making it even more difficult to do his job properly. Because he refused
to comply with the medical group’s demands, the physician was
terminated from the group’s employment. After termination, the medical
group refused to give patients the doctor’s new practice location and
phone number, causing patients to believe they had been abandoned.
The attorney in this case presented the jury with overwhelming evidence
in support of the doctor during a 3 month trial. She had nearly 20
physicians and 20 patients testify on the doctor’s behalf, including the
chief of staff of the hospital. Also, more than 45 letters were submitted
from parents of the children the physician had treated that stated they
were lied to about the physician’s whereabouts and other facts.
Obviously, given the very large jury verdict, her argument was more
convincing than the medical group’s position that managed care did not
at all influence their financial decisions!
Although this level of superior court case is not controlling law, this case
does seem to signify a change in tide on managed care cases. Given
the large amounts of media attention on managed care and many
widely publicized legislative changes, the public is quite informed about
problems of such corporate entities. Further, it is likely that at least
some of the jurors in this case had had their own negative experiences
with a health maintenance organization, or knew of a friend or family
member with a bad experience.
We as dentists must constantly remember that a managed care plan
does not change the level of care or treatment decisions that is owed to
each and every patient regardless of the insurance coverage that
patient has. New graduates frequently get caught in such a trap; feeling
that they must do what their employer dentist dictates, or what a
managed care contract demands. Regardless of when you graduated
from dental school, who you work for, what kind of insurance plans your
office accepts, as dentists we all have individual liability and
responsibility for all of our treatment, treatment related decisions, and
failures to treat. The buck stops with you!
© Bette Robin, DDS, JD 9/98
groups providing treatment via health maintenance organizations? Our
San Diego medical colleagues recently struggled with this question in a
widely publicized case involving the termination of a physician from a
medical group because he failed to compromise his quality of care.
San Diego superior court decided we don’t have to go too far!
The jury awarded the physician 2.5 million dollars for his wrongful
termination. This physician, whose name was not released, is a dual
board certified doctor in both pediatrics and gastroenterology. He
worked for the defendant medical group for over 12 years and this
group provided the majority of physician staffing at the Kearny Mesa
hospital in which the physician worked. The doctor claimed that the
medical group demanded he compromise his quality of care to patients
to provide the group with a better economic return. He specifically
claimed that he was required to spend less time with patients, was
urged to forego diagnostic tests, and was constantly pressured to
perform expensive, revenue generating, invasive procedures. Further,
the physician claimed that the hospital was chronically understaffed
making it even more difficult to do his job properly. Because he refused
to comply with the medical group’s demands, the physician was
terminated from the group’s employment. After termination, the medical
group refused to give patients the doctor’s new practice location and
phone number, causing patients to believe they had been abandoned.
The attorney in this case presented the jury with overwhelming evidence
in support of the doctor during a 3 month trial. She had nearly 20
physicians and 20 patients testify on the doctor’s behalf, including the
chief of staff of the hospital. Also, more than 45 letters were submitted
from parents of the children the physician had treated that stated they
were lied to about the physician’s whereabouts and other facts.
Obviously, given the very large jury verdict, her argument was more
convincing than the medical group’s position that managed care did not
at all influence their financial decisions!
Although this level of superior court case is not controlling law, this case
does seem to signify a change in tide on managed care cases. Given
the large amounts of media attention on managed care and many
widely publicized legislative changes, the public is quite informed about
problems of such corporate entities. Further, it is likely that at least
some of the jurors in this case had had their own negative experiences
with a health maintenance organization, or knew of a friend or family
member with a bad experience.
We as dentists must constantly remember that a managed care plan
does not change the level of care or treatment decisions that is owed to
each and every patient regardless of the insurance coverage that
patient has. New graduates frequently get caught in such a trap; feeling
that they must do what their employer dentist dictates, or what a
managed care contract demands. Regardless of when you graduated
from dental school, who you work for, what kind of insurance plans your
office accepts, as dentists we all have individual liability and
responsibility for all of our treatment, treatment related decisions, and
failures to treat. The buck stops with you!
© Bette Robin, DDS, JD 9/98
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DrRobin@BetteRobin.com
17482 Irvine Blvd., Suite E
Tustin, CA 92780
Tustin, CA 92780
877 DrRobin
Tele:
714.421.4407
Fax:
714.398.8808