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Writings of Dr. Charles
Phillips - The stories of the last Tuesday and
Wednesday on the obstetrician and "perinatologist" Dr. Hamid Safari of Kaiser Fresno
reminded me of my several interactions with him during my 18 months of
ER work at Kaiser Fresno 1997-1999. So I have a few comments
to add:
1) he was extremely arrogant;
2) he liked to apply rules that kept
patients out of the hospital - Kaiser's primary money making goal -
even though it put pregnant women at high risk; in one case a woman
with excessive vomiting suffered her third miscarriage related to his
blocking of admission;
3) he had no hesitation to cause extreme
pain - the opening of a full C-Section incision without giving an IV
narcotic first to block the pain; I heard the screaming, saw what he
had done, and told him in the hall that I was ashamed to share the same
profession;
4) that he was part of a department that
tried its best not to come down to the ER to solve OBV-gyn problems and
in particular told us to call the general surgeons instead for problems
with potential miscarriage below 23 weeks gestation - as if those
fetuses who might have limited brain function due to being too early
should be viewed as abdominal tumors.
Thus I have no problem believing that he
was just as bad upstairs in labor and delivery - the mixture of
arrogance, do things too fast, ignore pain control, keep people out of
the hospital on phone calls, delay expensive treatment like C-sections,
and generally keep patients at risk. Pregnant patients at
risk generally mean their fragile passengers put at
risk.
The episode in question of pulling a head
so hard as the shoulders got locked up at the pelvic outlet (shoulder
dystocia) so as to severe the spinal cord is awful. I have
not heard of it in my decades in medicine.
But as Charles Ornstein, LA Times
reporter who should get the Pulitzer Prize for his Kaiser articles,
stated - the real story is about how Permanente can keep such rotten
apples. To me it is about a rotten barrel - one that attracts
and keeps rotten apples.
The principal motivation for physicians at
Kaiser is to "vest" in the partnership so that they can work their way
toward the $15,000 a MONTH retirement program after 20
years. The key talent needed is to say "no" to expensive care
and keep the patient/passenger at maximum risk. The legal
department through Risk Management will have Cleaners who can mop up
the blood and guts and cover up the problems that
happen.
The errant physicians actually rise in the
ranks to the top because they have proven that they will follow the
"group ethic" of business rather than the Hippocratic Oath of
patient primacy. It is almost like the Mob or a gang in which
you have to have some hits to get ahead. Or else how
can you prove yourself to be worthy of the partnership?
The real story is the vengeance Kaiser
heaped upon the physicians who finally - not quickly - found that Dr.
Safari was so dangerous as to pull them into the tar
pit. Rather than being at the top - as the "high risk
pregnancy" expert - he was the "high risk" physician making the whole
department stink. One of the physicians got out of the
business. Another commutes to work; 2 hours each way - seeing
his family on weekends. All seemed to have lost "bonuses" for
speaking out.
Permanente runs Kaiser.
Permanente is a sick corporation with the goals of fooling the
public with white coats. Long training is turned on the
public to give the illusion of care. Increased death follows
increased risk from their many strategies of doing less to make
more. This year KP will make some $2 billion in profit - half
goes to the physicians.
My own recommendation is that the top
Permanente leadership go to jail for a long time.
They have spent 60 years in perfecting the illusion of care and many
innocents die. All those who have spoken up against
Permanente should be called back in to be part of the solution - a new
medical care organization that forces white coat physicians to live up
to the white coat ethic.
Charles Phillips, MD, FACEP
Cross Referenced with:
https://kaiserpapers.com/californianews/kpchildrenstories.html https://kaiserpapers.com/californianews/noonewouldlisten.html original source - http://www.latimes.com/news/la-me-kaiser16oct16,0,684129,full.story?coll=la-tot-topstories related story - The United States has a sharply higher rate of women dying during or just after pregnancy than European countries, even some relatively poor countries such as Macedonia and Bosnia, according to the first estimates in five years on maternal deaths worldwide. - http://www.reuters.com/article/newsOne/idUSN1339620220071013?sp=true mirrored for historical purposes and supporting document at: https://kaiserpapers.com/nationalnews/materialdeathrate.html Kaiser Responds to the above article at: http://xnet.kp.org/newscenter/kpresponds/2007-10-15.html and we have mirrored the response for historical purposes with brief commentary at: https://kaiserpapers.com/californianews/kaiserresponds.html |