Patients protest doctor’s dismissal
By Kevin Kelley for Westlife –
About 50 protesters demonstrated in front of St. John Medical Center Sunday afternoon to protest the termination of Dr. George Randt’s contract with Cuyahoga Physicians Network.
Cuyahoga Physicians Network is a for-profit practice organization owned and managed by the Sisters of Charity Health System. Randt had been seeing patients at Westlake Family Health Center, a Detroit Road practice owned and managed by St. John Medical Center.
In a letter to his patients, Randt said he was informed his contract was being terminated on April 1 by Cliff Coker, president of St. John Medical Center. The reason given, according to Randt’s letter, was “lack of productivity and generation of excessive overhead expenses.”
Randt said he was told he wasn’t seeing enough patients per hour.
Randt said he was blindsided by the termination of his contract.
“Nobody had come to use before and talked to us about our revenue generation or expense generation,” he said. Randt told reporters he received a bonus last year and his contract had been renewed in January.
The contract of Dr. Patricia Radigan, who did not attend Sunday’s protest, was also terminated.
Westlake Family Health Center sent a letter to Randt’s patients dated April 19 stating Randt will no longer be seeing patients there after April 30 “due to restructuring efforts.” The letter provided the names of other physicians patients could see and also offered to transfer medical records to other physicians.
St. John Medical Center spokesman Patrick Garmone said Cuyahoga Physicians Network had contracts with the two physicians and exercised rights within those contracts. Citing confidentiality issues, he declined to further comment on why the contracts were terminated.
Garmone also disputed several facts put out by Mobilize Ohio Movement, which advocates a single-payer health care system and organized Sunday’s protest.
Randt’s patients have not been made “medically homeless” as Mobilize Ohio Movement’s press release stated, Garmone said. As a Catholic hospital, St. John Medical Center would never deny care or access, he said.
Garmone also disputed a quote the organization attributed to Randt saying a hospital official said St. John Medical Center could make a profit if physicians “would admit just one more Medicare patient a month.”
“That’s an untrue statement,” Garmone said, adding the hospital was “slightly above break even.”
Garmone said Randt continues to have admitting privileges at St. John.
But Randt told West Life his admitting privileges had been temporarily taken away for two days.
Randt, 69, told West Life he did not yet know if he would try to start up or join another practice.
“I’m just trying to get through the rest of the day,” he said as his voice broke.
Randt said his termination underscores a larger problem in medicine — the inadequate compensation primary care physicians are given by insurance companies compared to medical specialists.
Randt told protesters that primary care physicians need to spend an adequate amount of time with each patient because taking an adequate patient history is 70 to 80 percent of making an adequate diagnosis.
“To me, medicine has been and should remain a profession where physicians should not be labeled as providers, and patients remain patients, and not consumers, or worse, customers,” Randt said.
Randt criticized the growing competition between the Cleveland Clinic and University Hospitals health care systems as wasteful.
“We don’t need complex and lavish physical facilities to do quality health care,” he said. “Most patients don’t care about fancy hospital rooms, valet parking, gourmet meals, the artwork on their walls or flat-screen TVs,” he said.
Carrying signs saying “Patient care above profit” and “Patients first?” protesters heard from a number of speakers, including two Maryland-based doctors from Physicians For a National Health Program.
Edwin Grover, a patient of Randt’s from Bay Village who attended the rally, said he was appalled that his doctor’s contract was terminated.
“He takes a lot of time with his patients,” Grover said. “I don’t know where I’m going to go next.”
Ken Jensen, another Randt patient who attended the protest, said he would like to hear a good definition of “medical productivity.”
Jensen said Randt spent considerable time with his patients.
“He’s very thorough,” he said. “He’s willing to listen.”
Jensen, also of Bay Village, said he doesn’t know where he will seek medical care from now on.
“As patients, we’re left in limbo here,” he said.
Effective primary care can eliminate the need for specialist and hospital services. Perhaps Dr. Randt was too good a doctor and his effectiveness was competing with the hospital/specialist business model.
The prejudice against primary care is an extension of the bias of conventional medicine against nonproprietary methods. Find a complex, expensive technological treatment for a condition that requires years of subspecialty training and at best results in symptomatic benefit that keeps the patient dependent on the treatment (thus generating a recurring stream of income) to perform instead of actually solving the problem—that is the business model of conventional medicine.
I personally do not use conventionally oriented physicians except as a last resort because I have always found better “alternative” treatments
These treatments have in common the lack of patentability. Patentability is the driving force of advancement in conventional medicine; we get the best proprietary medicine, but it is not the best that medical science has to offer and as a result we have procedure oriented specialists (with procedures that are all too often disappointing in their results and often inappropriately applied)or drugs that are outrageously expensive.
We need primary care doctors who are problem solvers. (“to many specialists, not enough engineers” to paraphrase a famous saying).
I am in favor of public option not single payor because I believe the government program will benefit from having to compete with the private sector.
I propose to create an HMO in which a primary care doctor who is trained in the best alternative methods is given a panel of say 2000 patients each paying $500/month therefore generating $1 million/month in revenue for that panel. If the doctor is successful in “solving the patient’s problems” without utilizing expensive proprietary/hospital services, an excess will accumulate in that doctors account and eventually distributed to the doctor as a bonus. Actuarial analysis will determine when an excess has occurred and will also incorporate risk sharing so that insurance risk is distributed and no doctor has to take on any insurance risk.
Current health care premiums have built in the excesses of hospital and and specialist medicine. Eliminating these excesses provides the profit and the basis of the new business model. Creative problem solving at the primary care level utilizing nonproprietary methods will reestablish primary care as the premier medical specialty by providing services that are more valuable than the specialist/hospital options. The evidence based paradigm is not replaced but supplemented by the more practical paradigm of what is the evidence that a particular treatment is working in an indivual patient. The PCP is freed from the constraints of the fee schedule and from the evidence based paradigm to do whatever he/she thinks is the best treatment and their good judgement, experience and problem solving talents will be rewarded.
Charles H. Bagley, M.D.
Conventional medicine cannot deal with competitive nonproprietary methods because they may not be in the fee schedule or nonmedical practitioners may be able to utilize them.
I agree with you that conventional medicine is too focused on how to make a profit, however private insurance existing along side a public option is destined to fail. It is the private insurance industry that has gotten Medicare into the troubles that it is in today because as long as they are in existence, they will fight for a piece of that action. As a medical biller, I see this every day. And as for your suggestion for a solution, perhaps you can afford a $500 a month premium, however the majority of Americans would not be able to afford that, myself included, and there would continue to be a high rate of uninsured people, which is the ultimate goal that single payer addresses, everybody in, nobody out.