Whistleblower Doctor--

The Politics and Economics of Pain and Dying

Executive Summary Chapters Appendices Contact		A one-month experience of working in three hospices in England convinced me to focus my medical career on alleviating pain and suffering of terminally ill cancer patients. After finishing my fellowship training in hematology and medical oncology (cancer) at the UC San Diego Medical Center, I resolved to find a way of integrating hospice principles and philosophy with my practice of cancer medicine. I worked at the LA County Department of Health Services (LAC-DHS) from 1979-1998, including nine years of directing the Pain and Palliative Care Service at the LA County+USC Medical Center (LAC+USC Medical Center). This Service become very popular with the patients, family caregivers, housestaff, nurses, and social workers. Overworked residents and nurses saw that we alleviated pain and distressing symptoms of their patients while reducing work for the hospital caregivers'. We provided their patients with outpatient hospice follow-up and 24 hour – 7 day phone availability that prevented many readmissions for uncontrolled symptoms. Unfortunately for the financial bottom line of the hospital and LA County – Department of Health Services, the better the Service controlled pain and distressing symptoms the less the Medi-Cal reimbursement. In the financial crisis of 1995, they closed my Service. I complained and they fired me in 1998. The LA County Department of Health Services is again in financial meltdown mode with a projected $1.6 billion deficit in four years. Since 2.7 million LA County residents depend on the LAC-DHS for health care, bankruptcy is not an option. Hopefully, stakeholders in healthcare quality in LA County can benefit from one physician's story of going through past LAC-DHS financial crises. MORE MONEY IS NOT THE ANSWER!! THE CURRENT SYSTEM IS FULL OF WASTE AND INEFFICIENCY!! …..more