A patient recently diagnosed with pancreatic cancer needed an oncologist who was in another insurer's plan. We did not have any physician referral list provided by the company, and my employee was referred to its Web site for the latest list of specialists, but there was no guarantee that those listed would be in the plan. And in fact, a number of them had already been called, and indeed, were not. Years ago, all I'd have to do is call the oncologist of my choice, and the patient would be relieved before leaving the office that he had an appointment. Dr. Saraceno's comments about wasting an inordinate amount of time is really an understatement.
Many patients run out of their measly prescription allowance within months.
Well, the last might be true, but not the first two as determined by extensive testing. The choices I had for a relatively young patient who had bypass surgery last year and has elevated lipids as well as hypertension and diabetes were not the drugs I would have chosen. The clinical manager was adamant about not using Pravachol and would send me a letter of denial. This is why HMOs must be accountable and liable for their decisions. We used to be able to get patients a consult, if they needed one, prior to them leaving the office.