Sunday, May 11, 2008

If I wasn't laughing I'd be screaming: Trying to get treated at Kaiser Permanente (Part II)

If I wasn’t laughing, I’d be Screaming
The difficulties in trying to get treated as a patient at
Kaiser Permanente

The following continuation of a story illustrates how difficult it is for a patient to be treated at Kaiser Permanente.

Patient has a prior hip injury, and 3 years later is re-injured and tries to a) determine the cause of injury and b) seek treatment.

Three years had gone by since I’d torn the acetabular labrum in my hip. Since it had slowly improved over time, the orthopedic surgeon (Dr. #2 from Part I of this saga) had not recommended surgery at the time, but recommended open debridement with possible osteotomy. The only reason I know his recommendations is because I order copies of all my medical records and get copies of tests if possible. You will see why this is a wise thing to do if you keep reading.

I did get PT with an excellent physical therapist (PT #1). I only got two visits though.

Over the course of 3 years, the pain was largely gone but many exercises aggravated my hip and I would go through periods of pain. I noticed that yoga and deep stretches made the problem worse, as well as squats and anything with a large ROM on that side.

It was in April of 2008 that it came to a head. I had been doing deep squats in a fitness class; I told the instructor they hurt my hip but she told me I was probably just doing them wrong (I wasn’t). She told everyone that. I’ll know better next time to listen to my own body and stop despite what someone else is telling you.

I had been taking the class for 2 months. One week, I went for a 5 mile hike in the mountains with some friends. One dance class later and I was in a world of hurt. My non-Kaiser chiropractor who had been previously helping with Active Release Technique, suggested that I might have re-torn the labrum.

I remembered what Dr. #2 had said 3 years ago, to come back if the pain got worse. I called and told Kaiser what he had said and asked for an appointment with him. He was no longer with Kaiser, they said, and they couldn’t tell me where he had gone. I Googled him and called his new medical office to ask for OS recommendations, but he never called back. Amazingly, I was able to request an appointment with an OS I found on over the phone by leaving a message with my Primary Care Physician. This was a new PCP for me by the way; I had to leave the old one because she was making up diagnoses and leaving them on my health record, part of the reason I got denied when I tried to switch out of Kaiser to another provider.

So I was surprised when I was able to get an appointment with a specialist without seeing my PCP in person. It had to have been some sort of miracle.

Kaiser told me to come in locally and get x-rays. This time I had done more research and when the technician told me she was only going to take the AP view requested by his office I asked her to do lateral and frogleg views. She reluctantly did frogleg but not the other views I asked for. I’m pretty sure it was unusual for the patient to ask for a different view. You have to look out for yourself in Kaiser though.

A short week later (another miracle) I was in Dr. #3’s office in Facility #3, armed with pen and a list of questions. He did some orthopedic tests and looked at my 2 x-rays on his computer screen. He promptly told me I had a cam impingement. I asked him to look at my previous labrum tear from 3 years ago and he said he didn’t have access to it. It turns out their computer system only shows them data from the last 3 years and it had been slightly over 3 years. I asked him if he could request it, and he said curtly, “What would be the point?” To compare it to a new one? I actually had the MRA disc at home and asked him if I should bring it in, but he wasn’t interested. He wanted to try PT and a cortisone shot first before any procedures.

He also declined to look at some x-rays I had brought with me, which included multiple views taken the previous week and 5 years previous (all non-Kaiser films). I looked at them with my chiropractor later and he pointed out to me where the cam impingement was 5 years ago, smaller. Many people had missed it, so I was impressed with Dr. #3 for at least finding it, if other aspects of the visit were frustrating. For example, he wouldn’t write a note to drop my fitness class or write me a prescription for pain. (He told me to stop using a crutch and I said I needed something for pain in that case.) I was supposed to see my PCP for these things, apparently, another trip out with my injury, and a $50 copayment.

Meanwhile I couldn’t exercise the leg muscles because of the pain, so I was losing a lot of muscle. I figured if I had torn the labrum (no MRA so I didn’t know for sure) that the inflammation needed to go down and exercising would just exacerbate it.

Obviously I had questions. I emailed Dr. #3 but he didn’t respond thoroughly at all, so the next time I wrote, I capitalized the word QUESTION, and had to send him 3 separate emails because Kaiser had a character limit. He still glossed over them and said we would need to talk in person for so much detail.

One of the questions I had written was whether I should do his recommended PT before or after the cortisone shot because I was atrophying but couldn’t do much without pain. He wrote back that PT would not help the cam impingement (it is a bone growth). Helpful!

So I knew I needed some time with him in person before he did the cortisone shot. I called his office and asked if my visit would include some time to talk to him first. “Of course,” the woman replied. “He’s not just going to come in and start doing procedures on your body.” She said I had 2 appointments scheduled for that day, one with him and one with x-ray, and I should come to his office before going to radiology. I told her I needed at least 20 minutes and asked how long the appointments were . 30. Great! Out of curiosity, I asked her what happens if you go over and she said that’s life, sometimes you go over.

While I was waiting for the visit, I went to see my PCP for the vicodin. It’s a Schedule III drug, so you can’t have someone just get it for you. More painful walking and a $50 co-pay. The first thing he did when he walked in was apologize for the co-pay. I was shocked. I explained what was going on, told him what a cam impingment was (a lot of family doctors don’t know), and asked if he could get me an MRA. No, he could only schedule MRIs. The surgeon would have to do that. He seemed a little out of it but he was really nice.

What’s funny is that several days later, I got a radiology report in the mail. It briefly said everything was normal. Attached was a note from him saying “Bones look ok.” That’s what passes for a radiology report these days at Kaiser? I’d even explained that a cam impingement was a bone growth, obviously not “ok”.

I also saw a new PT at Facility #4 (PT #2 as opposed to the one 3 years ago). Like nearly all PTs at Kaiser, she was excellent. She wanted to know what the surgeon’s plan of action was because she had read our emails (I guess they’re not private after all), and saw that he’d said PT wouldn’t help a cam impingement. She said he was known for hips. She was not surprised I had had a bad experience (mis-diagnosis, rudeness, pain) with Dr. #1. She gave me some exercises to try and asked me to call her when I learned the Plan. It seemed to straightforward and simple. Of course, it wouldn’t be.

I wanted to re-schedule my cortisone shot sooner because it hurt so much but I had already re-scheduled twice and I didn’t want to piss of the OS or his staff. My partner drove me to Facility #3, over an hour away. My choice; I picked the surgeon. The pain was so bad that I grabbed the wheelchair I saw sitting in the hallway. Ortho there was on the 2nd floor at the end of a long hallway. The chair had no leg rests so I had to tighten my leg muscles to keep my feet from dragging, more pain at the hip.

After I had paid my $50 copay for the office visit (yes I did just say that), the woman told us to go directly to radiology. No, I insisted, I had an appointment with the OS first. "I don’t think so, I’ll check.... Go talk to those people over there." After some explanation and low murmuring among themselves, they told me to wait.

I was grouchy; my pain level was an 8 out of 10. After 5 or 10 minutes, we were taken back to an exam room. Dr. #3 entered in a few minutes. I explained the weird visit issue because he said he had several patients. Like everyone else there, he seemed inconvenienced, but curtly asked for my questions. I told him my pain and atrophy was increasing and wanted to discuss surgery with him. (Cam impingements, I had learned, do not go away. They are a bone growth that keeps growing, and destroying cartilage, leading to pain and early osteoarthritis.) He said he wouldn’t even consider surgery until we’d waited 2 weeks to determine if the problem stemmed from inside or outside the hip joint. I explained my concerns about my schedule. I was just accepted into a competitive program that started in several months. I had a summer class and 9 free weeks for surgery recovery. He was unsympathetic. He said I had an unusually high level of pain for this diagnosis. No one else was unable to do these exercises because of pain. I was overly emotional and likely to have a bad surgical outcome because of it. “People are not cars.” Very true. At Kaiser, we’re cattle. Overall I was quite upset but also a little impressed that he didn’t want to rush into surgery. I would have been more impressed if he hadn’t been a Kaiser doc though. Surgeries are expensive.

He was good during the actual cortisone shot procedure; he seemed careful and compassionate, asking if he was hurting me. I was surprised after his curt office visits, but I guess some people are just like that. Oh, and I paid $10 for the test; definitely not that $50 I had paid for an office visit I supposedly didn’t have.

After the shot, I kept a pain log for the OS. The pain took 2 days to start reducing, and I’m not sure if it’s because of the shot or because I’m walking around less than I was the last 2 days. I will keep you posted.

Thursday, July 26, 2007


I saw Michael Moore's Sicko recently. I was ecstatic to see a movie which finally shows the truth about insurance companies and the state of healthcare in America. It was also interesting to see how some of them came to be that way. It turns out Kaiser was dissolute from the beginning. In a transcript between Nixon and Ehrlichmann, Ehrlichmann describes the proposed HMO's plan: "...The less care they give them[the patients], the more money they[the HMOs] make."

Another interesting note I read recently: In one part of the film, an 18-month-old girl is driven to the hospital due to a 106.6 degree fever. She is not treated there because the hospital cannot get permission from Kaiser, the girl's insurance. By the time an ambulance takes her to Kaiser to get the antibiotics she needs, she is dead. Kaiser is apparently trying to blow this one off as medical malpractice. When the doctor involved defended himself, he tried to claim that he thought it was asthma, even though phonecalls indicated he was asking to treat the girl with antibiotics for sepsis, a deadly bacterial infection. Kaiser is trying to use the excuse given in court by this doctor (who lost the court case, by the way), and excuse the fact that their corporate greed led to this girl's death.

Thursday, January 04, 2007

How to file a complaint with the DMHC against your HMO

You can download and fill out a form with the DMHC (Department of Managed Healthcare) here:

They also have an online comments form here:

Sunday, December 17, 2006

Another furious Kaiser member

Read for yourself...

Saturday, November 25, 2006

Kaiser, where the patients are treated like cattle

I recently heard someone refer to Kaiser as "treating patients like cattle", which seemed like an apt comparison, given that Kaiser docs see a different patient every 15 minutes. And we all know what happens to cattle... Read on for corporate cost saving resulting in death or injury.

Wednesday, November 22, 2006

Ever wonder if your (Kaiser) doc has been sued for malpractice?

Here is how you check their license. Go to:$lcev2.startup?p_qte_code=MDX&p_qte_pgm_code=6301

Kaiser rep misstates Consumer Reports' rating

A Kaiser sales rep intentionally misstated a CU report, saying that it had rated Kaiser Permanente as the best HMO, when in fact, it hadn't. Kaiser's HMO in the particular location didn't even have one factor which was rated best.

9 out of 10 trying to buy health insurance failed

9 out of 10 Americans who tried to buy their own health insurance failed, either because the price was too high or because they were denied converage due to pre-existing conditions. Read about it at

Healthcare profitability

Healthcare companies are making profits. For example, the top 12 in Fortune 500 are all profitable, with HealthNet having a 439% profit increase.


Grievance department at Kaiser? (Charged for services not rendered)

Has anyone tried to go through the grievance department at Kaiser?

I didn't even know there was one until I one day I looked at a receipt for an office visit and noticed that a test had supposedly been done when it hadn't. I contacted the doctor about it and it went through billing, and it must have been a big deal, because I got a lot of papers about it in the mail. Kaiser refused to refund my office visit payment, despite the fact that they had not provided the service as documented.

Problems with Kaiser (summary to date)

Problems I have experienced at Kaiser:
--Not getting help for my medical problems
--Getting locked into an expensive plan
--Kaiser docs making up illnesses which go on my medical record and prevent me from getting health insurance or changing said expensive plan
--Kaiser docs failing to do proper paperwork which resulted in false positives, preventing me from changing health insurance
--A horrible phone system which which can take about half an hour just to leave a message for your provider (there's no way to talk to them directly of course)
--False diagnoses
--Refusal to do the tests I need because Kaiser doesn't want to pay for them
--Being charged for things which were not done
--Kaiser doctors taking a long time to respond to messages
--Kaiser taking a long time to schedule tests (or any other procedure including office visits)

Kaiser cannot help patients using the system they have, which requires them to be both the doctor and the insurance company. They are not interested in paying money to help their patients, and so their patients are not helped. Being a patient with them has been a horrible experience, and if I could leave, I would.

Thursday, May 25, 2006

Kaiser using Google to focus web searches

This sounds like a great way for Kaiser to attempt to get better coverage on Google (i.e. fewer posts from patients and more pro-hmo propoganda). What do you think? I invite your comments...

Read about it

A patient's dream of exactly what to do with Kaiser...

Criminal activity at Kaiser?

This person claims on their site that Kaiser is conducting criminal activity, presumably to hinder financial investigation. View for yourself.
"Shortly before I was scheduled to look for billing discrepancies at Kaiser HMO, a gunman fired a shotgun in my general direction. I was obstructed in conveying my reports to my clients at Kaiser and subjected to intimidation by other Kaiser employees. A whole array of problems including arson fires began at that time and has continued to the present. I believe that two fires resulted in one fatality each."

Concealment of malpractice... and patient death

This is a shocking incidence of concealment, but according to its writer, malpractice is usually concealed, as no one wants to be responsible for a patient's death.

Got lawyers?

Here's a law office dedicated to helping Kaiser patients.

Kaiser in Wikipedia

Looks like Kaiser is taking exception to what people are saying on Wikipedia about them. Heh.
It might be this line: "Kaiser among others has paid fines for patient dumping." I say, get it out there. For a non-profit organization, Kaiser sure is concerned about profits and making themselves look good.

MIB intentionally withholding patient information?

Earlier I mentioned the MIB, the Medical Information Bureau. Recently, when I contacted them to find out if I had any records with them, they responded with a letter stating that they didn't have any under the following names. Following were several misspellings of my name. Since I had given them my name, birthdate, social security number, address, and other information, I don't see why there should be any ambiguity. They either have my record or they don't. Please tell me they don't file things in their database under name. How many John Smiths are there in the United States?

Another Kaiser member not using Kaiser

At the pharmacy (not a Kaiser pharmacy) today, I had a conversation with the pharmacist about a clinic. He mentioned that he was using it because his healthplan was bad. "Kaiser?" I guessed. He shared a story with me about his own bad experiences as a patient there. Isn't it ironic that we can't use our healthplan to get healthcare?
I hope he visits my blog.

Adword silliness

Isn't it ironic that there is an ad for Kaiser at the top of this blog? If anyone were considering them as an HMO, they would probably change their mind after reading more...