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On Tuesday, March 31st, I was contacted by the Administrative Director of my employer, Cuyahoga Physicians Network, a division of the Sisters of Charity Health System. I was informed that I must attend a meeting the following morning at my office with Cliff Coker, the President of St. John Medical Center. The purpose of the meeting was not divulged.
At the meeting, my associate and I were informed that our employment contracts with Cuyahoga Physicians Network were being terminated due to "our lack of productivity and generation of excessive overhead expenses". Mr. Coker told us that primary care physicians employed by University Hospitals Health Systems and/or Cuyahoga Physicians Network must meet productivity goals or risk termination. We were informed that we could no longer see patients after April 30th, 2010 at our Westlake offices. He suggested that we could have access to our patient records and go set up practice elsewhere.
He was a man on a mission and in a hurry to dispense with us. There was no indication of any concern for our soon to be "medically homeless" patients or our soon to be unemployed staff.
I admitted over 90% of our hospitalized patients to St. John West Shore Hospital for over 20 years. My contract with Cuyahoga Physicians Network had been renewed in January of 2010 and I had received a small performance bonus in 2009. In 2009 I personally received a plaque from St. John West Shore Hospital honoring me for 25 years of dedicated, compassionate, and caring service.
Both of us have established long-term relationships with many patients who have multiple and complex interacting health problems. As primary care physicians, we are required to do the thinking required in order to deliver the best primary and secondary preventative care, order tests and procedures only when needed, make appropriate decisions regarding specialty referrals and hospital admissions, provide support to patients and their families, and guide them through the increasingly complex health care maze 24 hours a day, 7 days a week.
However, I am not a "volume oriented" physician, or "compensation driven". I understand the business side of medicine and the need to control overhead expenses. Neither of us requested when joining Cuyahoga Physicians Network to be placed in a high rent facility with loads of excessive space and overhead, but that is where Cuyahoga Physicians Network put our practices.
I never had an unfavorable performance review, an indication that anything was wrong, or any discussion of issues relating to our practices. We and our staff and patients were just abruptly terminated and given 30 days to pack up and vacate.
It's tragic for patients, staff, and physicians when a health care system terminates rather than problem solves with clinically competent primary care internal medicine specialists that have been providing "medical homes" for their patients for years. Mr. Coker, the St. John Medical Center President, abruptly and without warning, terminated our practices and our connections with 2,500 loyal patients who came to 26908 Detroit Road, Suite 200, not because of the fancy facility, but because of their confidence in their physicians and our support staff.
The actions taken against us demonstrate in my mind that Mr. Coker's oft repeated quote "Every patient, every time." is hypocritical, disingenuous, and hollow.
Dr. George A. Randt, M.D.
Bay Village, OH
In 1970, I remember sitting with my mother and then young council man Dennis Kucinich at out dining room table discussing our lack of medical insurance and our inability to pay for my mother’s crucial and much needed pain medications. He talked of his caring for our situation and his plans one day for health care changes. My mother was a single parent and we had no one to turn to for help. We just wanted assistance and help to care for my dying mother and unfortunately we found no such help. My mother lost her battle with cancer when I was only 18 years old 2 years after that conversation. She died in my arms without the needed pain medication that would have enabled my mother to die without pain. It is very ironic that 39 years later, I am in the same position as my own mother. I made a promised to myself that I would never be without medical insurance and was also planning on never being in the position of living and fighting with cancer. But as life turns out, I am in the same position as my mother was almost 39 years ago. I have an incurable blood cancer. It causes tumors to grow through out my body and right now they are growing in my abdomen and chest. All we can do is knock the cancer back when I can not stand the pain any longer. I do not discuss how much time I have left because I plan on fighting as long as I can. I am searching for help but I am also in the fight to save my life. I am not sure where to turn to next.
We thought we had everything in place for the future. My husband worked at General Motors we had the assurance that retirement and security would be there when the time came. We would have the life and health insurance that had always been promised... Then I developed cancer. I have been fighting to stay alive and it has been a battle. It is not that I fear death, because I do not need insurance for that. I have a promise for a beautiful life ever after. It is the fear of the path I must walk to get there. Cancer has taken all of our savings and just about everything we had. Cancer is expensive to fight. It has put a burden on my family that will continue even after my death. But I held onto the fact that at least we had insurance.
I of ten hear people say I do not want health care changes, I like my health care. Why do I need to change what is not broken. I wonder if they have ever tried to use their insurance to fight cancer. I thought I would be fine in the beginning. Then I learned that the insurance has limits that you may not be aware of. I thought my insurance was the best. That was until I had to start chemo and I was facing an IV of a blue chemical waiting to drip. But before they could start the infusion we had to wait for insurance approval. My Oncologist had to give them more information /reasons why my cancer needed to be treated and why he was choosing one chemo or another. Why? When my blood counts bottom out my Dr made a choice of a drug that would pick the counts up. The shot would have been only once a month, but at $5000 each. The insurance company decided that it was too expensive and that I should have a less expensive shot that would be once a week with more side effects. Why is it right that the insurance company and not my Dr making those decisions? Every day I talk with others that have faced their insurance companies deciding what they would pay for and not always what the Dr wanted to use. In August a young girl only 21 died waiting for a bone marrow transplant. She had the donor; she did not have the money the hospital requires for her part of the transplant. Their was help with fund raisers, but not enough money raised and not fast enough. Why didn’t the insurance company pay more? The Drs and nurse try, but to often their hands are tied. My Oncologist orders a new med and will always ask what kind of insurance do I have before making a decision on which one to use. I want what is best to help me. During chemo we often were paying up to $500.00 for meds after insurance. Why doesn’t an insurance company pay more?
Changes to our insurance came in April when General Motors forced my husband to retire. We thought we would be OK. Within 2 weeks General Motors took away all of our insurances. We lost both health and life insurance. We thought that at least we had my insurance since I am younger. I have a preexisting condition it would be difficult to find new insurance. We were wrong they took that away also as of January. General Motors went through bankruptcy, allowing them to make changes in their insurance policies. They were facing hard times. So were we. Then in September I planned on going to Texas for a second opinion on a new treatment. My health has been declining and I need a new weapon. But before I could see the Dr and try to get answers we were told that General Motors had cancelled my insurance on September 7th without telling us. I was unable to see the doctor. It was a simple key stroke on a computer that cancelled my insurance and I was without help. I am fighting being dropped and they are looking into. But if it is reinstated my insurance will only be good until January 1st. Today was to be my 6 month check up to measure growth; it would have been a year late. I would have had the Cat Scans and blood work needed to let me know where I stand. But I do not have the money or insurance needed to find out. This is not the case of “what you don’t know won’t hurt you” it can and will. I am part of the middle class poor. I have been forced to cancel appointments, test and treatments. I already cut my pills in half and extend the time as long as I can between pills. I do everything I can to help myself.
My husband was a Chevy man and he believed what they promised with insurance that it would be there. We would make it. Now we have limited income and we have to pay out over $700 a month for my husbands insurance’s alone. He has developed a heart ailment and needs his insurance for surgery. Did my health and all of the problems cause his health problems? We search for insurance for me that we can afford and that will accept me. We are trying to keep our home. I want to die at home if possible. It seems like a small, but maybe impossible request.
I do not want to die soon or in pain. But more importantly I do not want the cycle to happen to my daughter. I want there to be insurance for her available without hesitations. I want companies to back up their promises of health insurance and life insurance for retirees. I want Congressman Kucinich to remember his words spoken long ago at an old Tremont dining room table and vote to pass healthcare now. I understand we do not want to pass on the debt, but I want to be able to live long enough to see a grandchild. I think it is time that when someone is fighting cancer that all of the energy should go to that and not on how to pay for the bills. Recently I lost another friend to brain cancer. He was fighting and dealing with insurance up until his last week of life instead of enjoying his last days. I am a fighter no matter if it is health care or cancer and I plan on beating down both. We lost so many friends to cancer. They were warriors! We need a cure.
- Fern, Cleveland
On October 18, 2009, I developed a severe headache. In addition to the headache I had soreness in the neck and a reduced range of motion. After two visits to my primary care physician, I was referred to a neurologist. I opted to contact the Cleveland Clinic headache center and immediately had an appointment.
The pain from the headache was the worst I have ever experienced, including that of a kidney stone. It kept me immobile and reclined on the couch or in bed for five weeks. I was unable to live a normal life and felt like mine had ended and I was doomed to the couch for the rest of my life.
Due to the neck pain and the limited range of motion and the intensity of the headache pain, the neurologist ordered an MRI of the cervical spine. Medical Mutual of Ohio denied that procedure. The doctor appealed the decision and it was again denied. At the time of the second denial, it had been five full weeks of intense pain that was not relieved by anti-inflamatories or other medications.
At this time it has been 7 ½ weeks since the onset of this headache. I still have pain in the neck area going into the shoulders and sometimes down the arms. When my neck tires, the headache pain increases. At the last evaluation on Monday, December 7, 2009, I was told that my neck muscles were locked in a spasm and I had a rather limited range of motion. I was given exercises to do for that, but they increase the intensity of the headache pain. My neck cannot be treated appropriately because we are flying blind without knowing what exactly is wrong.
Medical Mutual of Ohio, in an effort to decrease the amount they pay out, has added weeks of misery to me. I have been unable to work due to this or lead a normal life.
- Deb, Kent