(This article first appeared in the March 2002 issue of California Broker Magazine as an open letter to fellow health insurance professionals. Reprinted with permission from Dave Leveque.)
I am mourning the loss of my mother to pancreatic cancer. She was diagnosed on October 30, 2001 and died three months later. You are probably wondering why I would mention this in California Broker Magazine.* It is because for two months after diagnosis, I had to navigate that treacherous road called “managed care,” – in particular a Medicare HMO. During the 15 years that I have been a group and individual [agent], I have heard every possible negative story or HMO joke ever told. But, during the short time that my mother lived after her diagnosis, I had to move to the other side of the managed care process. No longer was I just selling the product, I was living the product and watching my mother die.
They say the HMO system is broken and I would partially agree. What I was not prepared for was the jaded attitude of the people working in the doctor’s offices. At times, they seemed like robots. Without looking up, they would say, “Your co-pay is $5.” Never once did they ask my mom, “How are you feeling today? Can we get you anything?” I can say unequivocally that the reception I get at the veterinarian’s offices is friendlier. The compassion shown for my dogs at the vet is greater than what my mother got at her doctors’ offices.
Perhaps my biggest surprise was the incompetence and ambivalence of the doctors who treated my mother. At 11:30 P.M., they moved her by ambulance from one hospital to another because of financial considerations.
Before my mother was diagnosed with cancer, she was taken to the emergency room with a severe case of jaundice. The ER doctor wanted to admit her to the hospital that night. But, he was overridden by my mom’s primary care physician who sent her home and told her to get a CAT scan done on Monday. The CAT scan showed that the pancreatic cancer caused the jaundice. Was she sent home that night from the ER to save a buck? We will never know.
One of the problems I observed during my mom’s illness was the primary-care doctor’s attempt to have an answer for everything. He was clearly in over his head in regard to treating pancreatic cancer and should have noticed symptoms like my mother’s weight loss over the last year. The primary doctor completely inflated the danger and possible outcome of surgery my mother was about to have to clear a blockage. He scared my entire family, especially my father, into thinking there was a fairly good chance she would not survive the operation. When we met the surgeon and expressed our concerns, he gave us a funny look. He said the procedure was routine and would only take 45 minutes – not the three to four hours the primary doctor had told us to expect.
Although the oncologist my mom was referred to was adequate, his staff was cold, rude and obnoxious. The receptionist told us, “We are not an HMO office and we are only seeing your mother as a favor.” This was after my mother sat for one hour waiting to see the doctor while in severe pain. We asked the front desk person if there was a bed my mom could lay down on during the wait. Without looking up, she answered, “No, we are full up.” Her attitude was contemptible. My mom was dead six weeks later.
By chance, I saw a fax describing how current Medicare HMO patients could take advantage of a special enrollment period to purchase a Medicare supplement plan by December 31, 2001. Immediately, my parents dis-enrolled in the Medicare HMO and purchased a supplement, which allowed them to see the doctors of their choice. For the last month of my mom’s life, she was treated with dignity and respect by a new set of doctors and their office staffs. The difference in attitude and care was mind boggling. Should the type of medical plan you have dictate how you are treated by medical personnel? I think not. Kindness and compassion are such simple things to provide. Does a person with a HMO Medicare plan deserve any less dignity than someone on a Medicare supplement plan? I have shied away from naming any of the doctors, hospitals or the Medicare HMO plan that treated my mother so shabbily in the last months of her life. However I would be remiss if I did not mention the USC/Norris Cancer Center where optimism and that “personal touch” are everywhere. Thank you to everyone at Norris who helped my mom.
I want to close by saying to my fellow [health insurance] brokers that my attitude toward HMOs has changed dramatically since my mother’s illness. I still believe in the system, but the people working in the system need a major shake up in courtesy and compassion toward their patients. Do I have the solution to the problem? Perhaps healthcare personnel, including doctors, should get some sensitivity training. They should make sure that the person working the front desk and the back office is a “people person” – not a robot with no feelings. In what other business could employees who are so rude and inept keep their jobs? Keep in mind that a smile and a little compassion go a long way toward making people feel better about themselves, especially in life and death situations. I saw how rude, curt and jaded employees at the HMO office treated my mother. I also saw the warmth and care at USC/Norris Cancer Center and the gleam in my mother’s eye when she was told she was going back to the doctor she had before joining the Medicare HMO. The doctor knew her name, her history and related to her in a way that gave my mom strength and courage even though she had only a month to live. The system can work and will work when kindness and compassion are restored and primary care doctors understand their limitations when a major illness is involved.
This special report is provided to you courtesy of Ray Martin
