Disenchanted Doctor Latest to Flee Managed Care
Marking the latest case of a "growing number" of physicians who have "rebelled" against the "bitter pill" of managed care, Dr. Bill Davis, a physician in rural Winters, Calif., this summer left his $70,000-a-year job at Sutter West Medical Group and started a not-for-profit health care foundation, the Los Angeles Times reports. During his tenure at Sutter West, Davis said he had to treat as many as six patients per hour and tackle a "mountain of paperwork," even for simple procedures, Davis said. "I got tired of watching patients having to wait for oxygen or pain relief. I became a thorn in their side because their big-city brand of medicine wasn't doing justice to people in this town," he added. Buoyed by the support of Winters' 5,200 residents, who joined Davis in a stand against managed care, Davis formed the not-for-profit Winters Health Care Foundation. Through the foundation, Davis will treat low-income residents and Medicare beneficiaries, charging on a sliding scale. "Dr. Davis took a stand against that HMO, and we felt that he did it for us, the people of Winters," Esther Brewer, one of the clinic's organizers, said, adding, "And we know that if we lose this type of quality care, we'll never get it back." Winters residents call the new clinic a "revolt" against "doc-in-the-box" HMO medicine. Winters pharmacist Gary Bertagnolli said, "It's this small town's way of being rabble-rousers. People are tired of what's being handed to them."
To help Davis establish the clinic, residents collected $50,000 and revamped a vacant office, while a local attorney provided free legal advice and a bookkeeper volunteered to do the taxes. In addition, as a not-for-profit organization, the clinic can apply for government grants to defer the cost of treating low-income patients. "We're going to try to create comprehensive health care and find a way to pay for it," Davis said, adding, "That's the opposite of what insurance-based medicine does. They only do what's paid for." Winter residents hope to raise $500,000 to cover the clinic's $4,000 monthly operating costs and eventually offer Davis a small salary. Duarte City of Hope Hospital administrator Dr. Rex Green, formerly employed by a Pasadena HMO, called Davis "lucky" to have community backing. "Many places so desperately want the kind of country doctoring their parents enjoyed they'll dream up ways to make good doctors stick around. That's not going to happen in a big urban area," Green said.
Davis' departure from Sutter West has, however, created some "small-town tensions." While Davis says he has directed his attacks against the managed care industry -- not Sutter West -- two of his former partners "rarely" speak to him, and Sutter West managers have "resisted" releasing medical charts for many of Davis' patients. "From Sutter there has been only silence -- they figured my only option was to deliver pizzas," Davis said, adding, "But I thought one of my former colleagues might call to see how I was, at least concerned over whether I could make it or not." Sutter West spokesperson Nancy Turner said that Davis "refused to honor" his contract. "Sutter West never said he couldn't spend time with patients. But his contract obligated him to meet its requirements -- whether it was filling out paperwork or seeing a certain number of patients in a day," she added. While statistics on HMO "defections" remain "scarce," Dr. Marie Kuffner, president of the California Medical Association, said that she has met with "HMO dropout doctors" throughout the state. "They no longer feel conflicted every day -- nobody's breathing down their necks saying 'You gotta see the next patient,'" Kuffner said, adding, "Most don't care what it costs. They'd rather have their integrity" (Glionna, Los Angeles Times, 12/7).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.