Reflections on Nearly Thirty Years with Kaiser Permanente

 

This isn't going to be a particulaly long post, but it occurred to me that this might be helpful to other members out there. First of all, I have got to say I am very thankful to have had health insurance always available for our family. Even when traveling out of state or country, we knew we always had options for care and treatment. Secondly, with the exception of a single orthopedic treatment issue involving my hands (concerning prior orthopedic physician and not current), health care for the last few years has been pretty good. That said, here is a sampling of the Kaiser issues we have dealt with over the years.

• Declined emergency care or triage due to one Kaiser facility's closure.  Family member removed from second facility by ambulance.
• Severe hand/arm infection misdiagnosed by doctor almost leading to serious complications due to length of time infection had been going (and the introduction of predinisone).
• Misdiagnosis and incorrect treatment for repeated sinus infections.  Evidence of doctor not thoroughly reviewing treatment challenges in past episodes.  I finally discovered the underlying cause.
• Complaint filed due to rude behavior and profanity by doctor during routine visit.
• Orthopedic issue with hands incorrectly characterized with no assistance offered to point of locking fingers.  Changed doctors, and the issue is gone.

There is a reason that HMO treatment is sometimes referred to as assembly-line medicine.  The patient is often pigeonholed into the wrong category due to first impressions that are hard to break.  What I have learned over the years is that one really has to be responsible for ensuring the quality of care is correct.  Often it seems the nurse practitioners are the ones who have provided me some of the most thorough care over the years.  One of these also remarked that it's the patient who often knows the best when a particular treatment is not working or even what may be worth trying.

Bottom line, you have to be your own advocate with Kaiser--just like any other HMO.  That may likely mean fighting for the care you deserve at times and not accepting what you're told.  It doesn't necessarily mean changing HMOs, as I believe you'e likely to encounter these issues in most of these systems.

On the plus side for Kaiser, I will say we had the best pediatrician one could ever have.  He even went to bat with us regarding a particular issue with one of the kid's schools.  He was awesome.