SPECIALISTS: Op-Ed Blames Climate for Refusals to Provide Care

      Responding to last week's Los Angeles Times story about specialists who refuse to respond to requests for emergency room care because of gripes with HMOs, an op-ed in today's Times agrees that "physicians should never refuse to provide emergency care to a patient, regardless of the circumstances. It is the fundamental responsibility of every physician to treat patients in need. Period." However, Marie Kuffner, president-elect of the California Medical Association, and Loren Johnson, co-chair of the American College of Emergency Physicians of California's Emergency On-Call Task Force, note that a "lack of enforcement of existing laws intended to regulate the managed care industry and the continuing defunding of the state's health care system have combined to create a climate in which those dedicated to caring for patients are almost always penalized for doing so." The authors argue that the state must "enforce existing laws and close all loopholes that allow health plans to deny payments to on-call physicians," and "allocate more resources toward the provision of emergency care for those who do not have and cannot afford health insurance." Kuffner and Johnson conclude, "The HMO industry and the government continue to play a dangerous game of seeing just how few resources they can provide physicians and hospitals and still have them care for patients. We are now seeing that some physicians, against every instinct and all their training, are saying, 'enough'" (6/11).