Aneurysm

May 22, 1996

TO: All Patients Who Have Left Our Practice for HMO's

The other day I asked a friend why he looked so glum. He went on to tell me that a co-worker, a 46 year old woman with a history of heart attack had just died at the hospital. She had been transported there from work after complaining about stomach pains and bloating. When she was admitted to the E.R. her blood pressure was extremely low.

"Sounds like aneurysm," I told him.

"Steve, you're a dentist. Tell me how you knew that but the doctors at the hospital didn't. They didn't even run any tests the entire time she was alive there," he responded disconsolately.

"Sounds like aneurysm in a patient with an HMO," I said. His face turned ashen. I had made the perfect diagnosis, and I wasn't even there to check the patient. It's all a matter of dollars. The insurance company is trying to preserve theirs, the hospitals don't want to lose the limited funds the HMO's part with by running tests or performing heroic procedures to preserve life. So now her teenage children have no mother, her husband, sadly, perhaps unnecessarily, alone.

I don't know whether you're as satisfied now with your new dentist as you were when you were here. I don't know whether they take the same amount of time to clean your teeth, educate you and your family, save your teeth. I do know we see patients returning, often paying their costs out-of-pocket, rather than subjecting themselves to this lower standard of care. I'd like to know how your feel about your experience since you've left. Please drop me a line?

I don't know whether your employer gives you a choice of traditional insurance as well as mangled care managed costs managed care, or when the date for changing your insurance is. I can tell you that it is predicted that within five years there will be a backlash (and a major backlog of malpractice cases against HMO doctors) by employees who witness their health premium dollar paying for nothing better than Medicaid.

Please consider the costs involved in staying with your existing insurance. Costs that are measured in dollars by your HMO, and in devastated lives by families on a daily basis whose medical needs go unmet. They are the forsaken.

In the state of New Jersey, all employers with more than 25 employees must offer their staffs traditional (indemnity) insurance if they offer HMO's. Does yours? For more information, contact Lori or Betsy at my office.

The story I told at the beginning was true. It obviously isn't the only one, it's just the latest one. My concern is not to scare you into coming back. This is not a dental issue (although the levels of neglect are often high in dental HMO's), it is an issue that goes far deeper than teeth. This is an issue of life and death.

Respectfully,

Dr. Stephen J Markus