:: to the teeth ::    thoughts on social justice, medicine, race, hope and beats

"Another world is not only possible, she is on her way.
On a quiet day, I can hear her breathing." :: Arundhati Roy ::

"The most common way people give up their power is by thinking they don't have any." :: Alice Walker ::
Friday, May 20, 2005  

Last week I "voluntarily" resigned my position as adjunct faculty member and locum tenens provider at the University of New Mexico Hospital. I joined a long and growing list of people who have either been pushed out or have read the writing on the wall and chosen to leave.

For me, it was a solid push. The precipitating incident was a phone call i made to one of the family practice clinics. Our public hospital had just instituted a new draconian policy of up front payment prior to being seen. Sounds benign enough on the surface, it's how many businesses operate. yet this is a public hospital. Let me share a story that brings it all to light so that you can understand why i took the step that got me kicked out.

a 17yo woman, pregnant, is getting her prenatal care at an outlying clinic. Her doctor decides she might be dehydrated so she sends her to the hospital for evaluation. At the front desk this person is asked for $35. She doesn't have it. She is told to go home and come back when she has the money. fair play? after advocates (my friends) arrived, this young woman was admitted for two days for IV rehydration. this also happened to a 14yo pregnant girl two weeks ago. she was coming in for her first prenatal visit and was turned away at the front desk for lack of $35. Ask the CEO about this and he says it was an error on the part of the front desk folks. Well... yes. It was their mistake to believe that a policy put in place by him was ethical and worth following.

So the policy had just been put in place one month prior. Our CEO was saying in public that only 25 people had been affected and only 18 of them had been turned away. I didn't believe him. I didn't believe that there was even any data being collected. So here was my crime. I called a clinic and asked the front desk person if they were collecting data. This person stated that she was told not to speak to anyone about this new policy, she couldn't help me. she transferred me to her manager and that's where the sparks started flying. I identified myself as a UNM physician (that's what my badge says) and I stated that I was doing community based research. My research question was - "Are you collecting data on how many patients are turned away because they don't have their copay?" this really iritated the manager and she became defensive, I became frustrated, we went back and forth and finally hung up on each other. I never got my answer.

Turns out she reported me to her boss who reported me higher and higher and higher until it became this huge "thing." I got a call two days later from my boss who said that we had to talk. Bottom line, I was accused of misrepresenting myself as a UNM Physician and of doing research without IRB approval. I was told that my action (a phone call) was unacceptable and warranted immediate resignation or else I would have my privileges suspended and be reported to the state licensing board. Inflated charges, ruined credit. The same treatment many of my patients are reeciving financially by the same bullies. poetic justice? I chose to resign to avoid a large fight so that I could continue to pump my energy into creating positive solutions to this mess.

This is NOT going to stop me from speaking out. As a matter of fact, it has inspired me to organize the many people who have been kicked out or chose to walk away. We are going to start by creating a bumper sticker and tee shirt - "UNMH - Been There, Done That."


posted by andru | 5/20/2005 01:17:00 PM | |


What did you expect??!!!
No employer is going to tolerate an annoying, big mouth radical like yourself. You're better off on your own, rather than hypocritically excepting the convenient resources of the institution you so avidly protest.
You're a threat to them! If you're going to make waves, be prepared to swim! You're in the wrong profession, consider becoming a polititian or joining Greenpeace.

# posted by Blogger billkmd : 6/12/2005 7:37 AM  

doctor bill,

thanks for the words. i actually did expect it, being kicked out that is, which is kinda sad. in a university setting (not a private corporation) one would hope, at least in this free democratic country, to be able to speak one's heart and one's mind freely, especially since it was thoroughly researched data, not just liberal opinion. note that i have never been accused of being verbally abusive or loud, most of the time the hospital board needs to ask me to SPEAK UP so i can be heard more clearly. what seems to bother them all is that i speak out in public, not behind anyone's back. it's something i learned as a child and continue on to this very day.

and to be clear, i was "working" for the university for free, as a volunteer inpatient attending and medical student / resident preceptor. the paid work I did as a locums doctor actually earned the university money because they took a cut of my salary. my benefit was in getting ACLS courses at a reduced fee. and there is NOTHING convenient about parking at the university. my many parking tickets can attest to that. :>

another note, and this needs to be understood clearly, i have not and am not criticizing the mission nor the staff nor the institution itself. i am criticising the corruption of top UNMH officials who abuse their power, their sacred trust to care for their community and at the same time BLAME uninsured patients, my patients, for the health care crisis.

do you support corruption? if you saw it, knew about it, would you keep your big mouth shut?

finally, what i'm doing has very little to do with greenpeace, although i do share a love for nature. it has everything to do with real human beings having access to medically necessary healthcare services at affordable prices. it's called human rights dude. and i am in exactly the right profession. being a doctor is all about that or else what is it about? what part of thou shalt do no harm don't you understand? perhaps YOU need to join greenpeace so you can figure out what you are talking about. a few months on a boat in the arctic sea saving sealions and ramming oil tankers should make it all real clear...

and you know what? i am better off on my own. I feel unplugged (aka the Matrix). their empty threats of reporting me to the state board for using the word "ethics" too many times is now no longer even a threat, it's just empty.

perhaps history will be kind to each of us and when the dust settles on this local issue in a few years we will all be able to look back and see ourselves reflected in a better world, that is my wish. if it does happen that way, be kind and forgiving to yourself, i'm sure you are operating from the best of intentions even if you do appear to be hostile, ignorant and uninformed, it's probably not your fault.



# posted by Blogger andru : 6/29/2005 11:47 PM  

I hope you've axed the idea of the bumper sticker, instead focusing all your well-intentioned energies on helping people. Your actions (kudos to the ultrasound day at the topahkal) will definitely speak much louder than any bumper sticker out there.

and just to lighten this all up abit...speaking of bumper stickers:

Where am I going? And what am I doing in this handbasket?

# posted by Anonymous Maia : 7/03/2005 12:27 AM  

You did the right thing with University of New Mexico Hospital - and I always support to do what you believe in - even if it cost your job - you're the one that have to live with yourself man.

# posted by Anonymous Locum tenens jobs : 7/21/2008 8:50 PM  

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