KOIN Investigations 5/26/99 http://www.koin.com/news/koinvestigators/news-koinvestigators-990526-211001.html

No Time For Patients

Eric Mason, KOIN 6 News

What happens when you find they've taken the care out of medical care? Maybe it's time to get another opinion. But in some health plans it's not possible -- in others it may be too late, as one Portland hairdresser found.

If you think managed care is the best medicine, just visit an emergency room and talk with the doctors.

"You know what? When I cut his chest open to put in a tube there was hiss of air -- hiss ok? That means there was pressure in there. If he had waited a few more hours he'd be dead," said emergency room physician David Toovey.

According to Dr. Toovey, this case, which looked like a common cough, could have killed the patient. The most surprising part is that some insurance companies still want prior approval for such visits to the emergency room --despite a law to the contrary.

Toovey says it's time for patients to have more control when they believe they're not getting the care they need.

Michelle Miller is talking about the hand she used to make a living with. She is a hairdresser.

"It causes a lot of difficulty and pain while I'm working because I can't bend my hand in the angles I need to bend them," said Miller.

On February 17 of this year, Miller broke her hand and ended up in the emergency room.

From there she ended up at a specialist who put a cast on the arm, but not at the point where it was broken, according to Miller.

"He put a finger splint on. He was in an extreme hurry. He was very rude," she remembers. "I questioned him where the break was and we looked at the x-rays. He told me clearly this is where the break is -- where your knuckle meets the hand bone and he clearly did not cast the broken area."

When Miller says she started asking questions, she says the doctor put her off.

"He tossed a role of tape to me and told me to take this home with me and tape the finger to the splint. (That) was demeaning to me."

In all fairness, the doctor in this case was responding to a call for a surgical procedure. He did not want to be interviewed for this story, however.

In the end, Miller saw another doctor who took the first cast off and put another one on. This time the break was immobilized.

Now the break has mended but her hand has not.

"I've been told it's too late to operate and repair the damage," said Miller.

She now has trouble with the most basic movements, including putting on her son's shoes. The pain and stiffness never seems to go away.

"I think people are in too big of hurry and there are too many patients being seen in too short of a time span."

Emergency room doctors like David Toovey agree. But he says managed care, and more specifically HMOs, mean less time per patient. In the end, doctors have no time for patients.

"I think we have to have almost a revolution from the patient's perspective," said Dr. Toovey. "To say 'enough is enough. We're spending all this money and not getting quality service.' "

Doctor Toovey says under a law that passed two years ago, an HMO or insurance company can never block your access to an emergency room for any reason. He says many patients still don't know about that law.

We approached medical insurers about this story and they declined our offers for an interview.

Eric Mason, Special to Channel 6000