The Manipulation of HMO Medical Testing by Charles Phillips, MD FACP

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The Manipulation of HMO Medical Testing
By Charles Phillips, MD FACP - CPhil49401@aol.com
Fresno, California, April 22, 2003

XIII. Exhibits
#l - Kaiser Ads - the Promises:

     1a - website posting - "absolute.. trust";
       1b - Senior Advantage Ad - "we'd like to be there for you";
       1c - Another Senior Advantage Ad - "patient care comes first";
       1d A Third Senior Advantage Ad "secret opinion walking down the hallway";
       1e - A Fourth Senior Advantage Ad - "a plan you can trust"

#2 - "Patient" vs. "Customer" Detailed Essay;
#3 - Sample Cover of the Permanente Journal;
#4 - Kaiser Cartoon - why the lines will stay long;
#5 - Web Pathway and Article - "Selecting and Interpreting Diagnostic Tests" - and the table on Lyme's testing;
#6 - Abnormal Stress Test - read by Kaiser as "unremarkable";
#7 - Comparing Blood Counts:

        a. 7a - WBC - Kaiser - 1995 - Southern California;
        b. 7b - WBC - Kaiser - 1998 - Southern California;
        c. 7c - WBC - Kaiser - 2001 - Southern California;
      d. 7d - WBC - Kaiser - 1997 - Northern California (TPMG);
        e. 7e - WBC - Kaiser - 1998 - Northern California (TPMG);
        f.   7f - WBC - Kaiser - 1998 - Northern California (TMPC);
        g. 7g - WBC - Victor Valley Hospital;
        h. 7h - WBC - National Standard - not Kaiserized;
        i.   7i - WBC - National Standard

#8 - Renal Tests - Northern California - creatinine - upper limit set too high.
#9- Lyme Tests

        a. 9a-Topic Introduction ;
        b. 9b - Overview by Miguel Perez-Lizano;
        c. 9c - Kaiser's Lyme protocol - now taken offline by Kaiser;
        d. 9d - Dr. Donta's published protocol on Lyme - Boston;
        e. 9e - A Critique of Kaiser v. Dr. Donta ;
        f.   9f - One Lyme patient's experience with Kaiser;
        g. 9g - Another Patient's Experience;
        h. 9h -Yet Another Patient;
         i. 9i - $65,000 Award for Missed Lyme Disease and a Wrecked Life.

#10- Anthrax

a. l0a- Kaiser's Advice vs. that of the CDC;
b. l0b- Kaiser uses Anthrax Posting on Web to Recruit MDs

#11- Chest X-rays:

        a. 11a- Patient with CXR sent by outside ER;
        b. 11b-Kaiser Loses X-ray;
        c. 11c- Dramatized True Story - Kaiser Delays Ordering a Chest X-ray;
        d. 11d- Chest x-ray reading simply a checked box, not a description

#12- Underreading of MRIs

a. Contract Group Avoids Mentioning Cruciate Ligament and Minimizes Damage to the Meniscus Cartilage;

b. Correct Reading of the same MRI;

#13 - California Leads the Nation in HMO Penetration - [Bad News];
#14- Cover and page II of "The Evolution of Medical Groups and Capitation in California";
#15 - Fewer Physicians for More Patients

         a. Older Kaiser Doctors Pack their Bags;
         b. Physician Moves Away From Patients as More DistantTeam Leader
           Spin Picture to Look Like the Patient will have More Access;

#16- The Permanente Map;
#17 - Patients vs. Staff

17a. "External Customers" pictured as Drab People;
17b. Kaiser staff- pictured as a more elite group of people;

#18 - Kaiser's Dirty Little Secret;
#19 - Kaiser Colorado Spin on Physician Incentives;
#20 - Medicare Benefits Going Down;
#21 - Dr. Lawrence's Life Style:

     #21 a - $2,800,000 Home;
     #21 b Questionable Relationship to Watson Pharmacenticals;
     #21c -$14 Million Kaiser Investment for Caretouch, then Spinoff with Dr. Lawrence still on board;
     #21d - Home Forgiveness - "In Silicon Valley a new kind of house call"

#22 - Mr. Halvorson - Kaiser's New CEO - Caught with Huge Perks in Minnesota -Fooling his own Staff;
#23 - Bayer/Kaiser Fraud - Scheming to Defraud the Government on Cipro;
#24 - Kaiser Uses 990 to Emphasize Non-profit images with for profit physicians obscured;
#25 - Kaiser Tries to Look Benevolent (no KP stocks);
#26 - The Permanente Medical Group Clearly Has Stock;
#27 - My Own Physician Profile on the Kaiser Computer Note secret "Report Card" (that I'll never see);
#28 - Outcome Goes Down for the Poor and Elderly in Managed Care
#29 - Kaiser's Net Income $137 per Quarter - or $648 million a year (Now divide half of that among the 3000 Permanente partners) = $100,000+ per year in dividend from under treating and undertesting;
#30 - Kaiser Hints at Incentives but Down Plays the Amount Every Time;
#31 - Physicians Brag about being Part Owners;
#32 - The Tahoe Agreement;
#33 - Documents Disappear Easily at Kaiser - State Department of Corporation Investigator Notices.

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