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2000This web site is in no manner affiliated with any Kaiser entity and the for profit Permanente
kaiserpapers.com/robertpearl
To the family of Robert M. Pearl, physician with the Permanente Medical Group, we offer our sincere apologies that this material had to be publicly presented. The California Medical Board had this material in their possession for over one month and failed to address the serious issues that are raised. In the interest of the well being of the American Public and the interest in truth and transparency in the medical care provided the citizens of the United States, in particular those most vulnerable, including the Medicare patients, this material had to become public.
CLICK HERE TO VIEW INDEX OF
EXHIBITS MENTIONED IN THE FOLLOWING DOCUMENT
CHARLES PHILLIPS,
MD,
FACEP
April 18, 2008
Medical Board of California
Central Complaint Unit
1426 Howe Avenue,
Suite 54
Sacramento, CA 95825-3236
Dear Complaint Unit,
Introduction
As this is a complaint by a physician against probably the most powerful physician in California - the Executive Director and Chief Executive Officer of The Permanente Medical Group (TPMG)1
-I must start by asking that you appoint an Independent Investigator with "Blue Ribbon" credentials to even read this letter further. To some extent the Medical Board's integrity might come into question if this is not handled prudently and in the interest of the millions of patients and potential patients under this man's indirect care and/or control2. This will be a complaint about dishonesty, a particular lie repeated in many leadership environments - thus a major ethics violation. And the purpose of this repeated lie was threefold: first, to turn the tide of bad press at the time toward lethal errors at Kaiser two hospitals in the South Bay, second, to try to sell to the world that Kaiser's particular patented style of information technology is the answer to almost all medical errors3, and third, to once again encourage patients - particularly seniors - into joining the huge HM04 by painting himself as an empathetic victim (in realty becoming Victim-in-Chief be turning all this into a giant, multi-media press release).
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1 In most of Kaiser's positions, rotation occurs at five or ten years. But Kaiser is particularly proud that it has had very few Medical Director's of TPMG-starting with "The Founder" Sydney Garfield, MD. Dr. Pearl has seen and survived many organizational "near death" situations; he has no prospects of being replaced as TPMG CEO in the foreseeable future. [Dr. Garfield only stepped back from leadership when the Medical Board of California caught him in a lie - pretending that a graduate surgeon was a resident so as to avoid a license review prior to California practice.]
2 Contrary to the Medical Board's general policy that corporations cannot practice medicine, the Kaiser Care Management Institute (CMI) feeds into frontline medical computers all over the country "best practices" and "smart sets" whereby care is marginal at best and denied at most. This information is created, packaged, and sent out (? Norton's Ghost program] to all frontline computers - check the CMI on the 16th floor of One Kaiser Plaza.) The "Right thing to Do" becomes the only thing to do when every frontline physician is being watched to see if they are "managed care suitable" - a for profit partner path leading to a multi-million dollar valued retirement package. It is as if
3 Turning medical records into electronic information can actually worsen health care. Medical records are much more easily altered after errors. There is also a built in time delay between data entry and data reading - wherein deaths have occurred. And control over distant physicians often ruins the physician advocacy promised to the individual patient and promised in Kaiser ads. (See again footnote 2).
4 Seniors make up 10% of Kaiser's patients but represent 20% of its revenue - see "Kaiser Permanente" bond pamphlets available from New York City. Plus seniors have a hard time suing when there is error due to MICRA caps on pain and suffering and the lack of a senior's lost job revenue to recoup. Kaiser needs to keep its patient volume close to 9 million to make a good profit, and seniors are good to recruit once you have perfected how not to give much care, e.g. don't test those couch potato type of patients for diabetes even though many have that illness. Kaiser admits it misses many diabetics.
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Reading further will mean that whoever is now continuing to read this letter believes himself or herself to be coming to it with the right credentials and motives to achieve the goals of this Consumer Affairs department under the Governor - to protect patients first. Whoever that is must be ready to take pressure from others - as this letter gets more widely read. Many will try to protect Kaiser as supposedly as the only "private" solution to medical care out there. Such parties will try hard to close this complaint ASAP.
The Kaiser Errors that Set UP the Need for the Lie
November 2005 was a very bad time for the public relations of Kaiser ("Thrive" campaign) due to two terrible mistakes at Kaiser Permanente's South Bay region. First, Chris Wibeto, age 21 (Exhibit A + B) got "someone else's medication" at Kaiser's Santa Teresa Medical Center and died! And second, Josephine Frances Hart died at the Kaiser's Santa Clara Medical Center due to an major error [Exhibit C]5. Both errors had actually occurred during the summer of 2005, but the public was just learning about them in November of 2005 - a crucial enrollment time for seniors. As we will see, Dr. Robert Mark Pearl (living in Los Gatos) found a way out for Kaiser and himself as TPMG chief and highly connected to the two hospitals. He decided to make up a story that he, too, was a victim of medical error through the death of his father.
Websites. Radio Ads. etc.
Dr. Pearl, has for years tried to represent that he trusts Kaiser so much that his own children were born in the South Bay Kaiser facilities. He has gone on in many radio ads to say that the good care his family has received can be expected by all those who join. [He does not explain in the radio ads that he is the boss and has the "blue dot" treatment of Kaiser insiders.]
Although other physicians have leant their names to local ads -laser eye surgery, or heart surgery at a particular hospital, etc. - no other physician has gone so public (throughout Northern California) to claim in countless radio ads6 that the kind of care he gives and the type of care his family receives under Kaiser is excellent. He has, therefore, also publicized the care of his family - thus escaping the usual protection of HIPPA regulations on super privacy.
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5 Note also another death in 2007 [Exhibit D] that sounds similar. This is what happens if there is no responsibility taken in at the top. The Oakland leaders create their own glass ceiling whereby they stay shielded from the pain and suffering below. These MD and non-MD leaders prefer their high rise view - sunrises over Lake Merritt and sunsets over the Golden Gate Bridge (see online picture from the 27th floor where both Mr. Halvorson and the top Permanente Federation MODs have offices).
6 I commute in the Fresno area and heard him on the radio many times. The Central Valley is a rapid growth area for Kaiser at a time when some of the urban Kaiser members are withdrawing. The goal is to keep membershlp even - through a $45 million a year ad campaign.
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Medicare has ruled that Websites are just as much an advertising tool as the traditional press releases and radio ads, etc. All constitute advertising efforts as the public is trying to choose TRUST to place their lives in the hands of strangers with white coats.7 Were Dr. Robert Mark Pearl to initiate and/or participate in a lie campaign (Dr. Pearl as family victim due to father's death as we will see below) - particularly aimed at gullible seniors - he would be in violation of the Medical Practice Act of California. And the use of the lie once twenty six months later means there is no harm in repeating a lie that worked the first time.
The Lie that Made the Headlines
What he did in November of 2005 is to say that he found his own father dead in his own "living room floor" in Florida8 (though far from a Kaiser hospital) -later discovering through the Kaiser computer system that the death was due to an East Coast medical error by two physicians.
[See Exhibits E, F, G, and H.] So he could, therefore, empathize with all those around the country who saw errors take their love ones. He told this story to many.
I became immediately suspicious because I had heard such stories before used to promote topics or people. First there was the classic story of an airplane crash in Nebraska (Exhibit I) that through the analysis of bad care gave rise to one of the most successful medical teaching programs in history - Advanced Trauma Life Support.9 [As a plastic surgeon, Dr. Pearl would know this story and training course well]
Then, there was the story of Kaiser CEO, Dr. David McKinnon Lawrence, where the dying scene of his father in Kentucky is used to promote Kaiser where care would have been better. This 1999 tale has always sounded fishy to me. Dr. Lawrence used the supposed disorganized care to kick off his poorly selling book from CHAOS to CARE [Exhibit J] written at a retreat in Oregon as he sat out his last year doing nothing else and fully funded (supposedly to teach Mr. Halvorson - the new Kaiser CEO, President, and Chairman of the Board - what to do).10 [Dr. Lawrence's book was written to try to deal with the nationwide applause when actress Helen Hunt complained about the asthma care of her child in an "HMO" in the movie "As Good As It Gets." Dr. Lawrence tried to make the Kaiser care of asthma look better than that in private practice - which it is not.]
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7 The white coat and its ceremony (every US medical school) is the link to humanistic ethic of Hippocrates - promising unwavering patient advocacy for free or slave by both oath (this world) and covenant (the next world).
8 As we will see, in another story it all happened in Florida - though family living room not retracted.
9 This course is taught in many countries and is rumored to entirely pay for the American College of Surgeons in Chicago. I have been an instructor for this course in the US, Canada, and Saudi Arabia - so I know it well. I do believe this first story of family trauma told by a surgeon.
10 Mr. Halvorson soon after arrival promptly asked everyone to recheck Dr. Lawrence's giant contract with IBM for the CIS Informational Technology (IT) program and scrapped it - perhaps a loss of $50,000,000 - for the Wisconsin EPIC system (both called "KaiserConnect" as if developed internally). Dr. Lawrence promised to leave the medical field in a goodbye magazine Interview but popped up at Watson Pharmaceuticals, McKesson, Inc., and then promoting Kaiser In England.
---------------------------------
Dr. Robert Mark Pearl's story is as follows:
- His father, Jack Pearl, was a New York City dentist [Exhibit K] who was a typical Snow Bird heading to Florida quiet regularly and later retiring there (true so far);
- As his father then had two physicians in the two states [and not all connected to a massive computer system like Kaiser] both physicians forgot to give him a Pneumovax injection after he had his spleen surgically removed; [this is starting to get fishy as Dr. Pearl would have learned about the need for this shot years ago - I did in the late 1970s as hospitals chased down past splenectomy patients to add the shot - and would surely have told his father to get this solved];
- Next, we are told that his father was visiting Dr. Pearl in California [see Exhibit E again] far from a Kaiser Hospital and died suddenly in his living room of sepsis. [This seems very unlikely - almost the only people who die this fast from infection are those with anthrax or meningococcal infection of the blood, both with sudden shock; whereas, problems pneumovax would help to prevent (streptococcal pneumonea infection) come on a bit slower];
- In another story, he had his father dying in Florida [review again Exhibit Fa and Fb] far away from California; but both places cannot be right;
- Then, after the death of his father, Dr. Pearl found in his father's pockets little pieces of paper that he, Dr. Robert Pearl, put together and fed into a handy Kaiser computer - the complete computer answer was clear and quick - No pneumovax shot had been given! [read again Exhibit G]; [Normally seniors do not keep in their pocket the immunizations they have been given; perhaps he had it and perhaps he didn't (though we will see it was irrelevant to death).]
- The East Coast physicians in states without Kaiser - New York11 and Florida - should not be blamed (per Dr. Pearl) for this error; they simply do not have Kaiser's massive computer system needed to sort all this out in advance to prevent this supposedly needless death.
- This story was spread widely by Dr. Robert Pearl [See again Exhibit H] - as the head of TPMG [see Exhibit I] he speaks often and all over the country. [He actually also has titles outside of Kaiser as a spokesperson for other MDs committed to manage care (the withholding of care with a smile).]
11 Kaiser was at one time bought its way into New York but then got out - patient's wanted to choose their own doctors. The New York Attorney General sued Kaiser for $1 million on fraud on the way out (as did the Texas AG later as Kaiser left Texas after 20 wrongful death suits in Dallas in their first year). Kaiser has left as many states as it is now in. California is the HMO's safe haven due a host of favorable policies and laws. The Department of Managed Health Care is more on the side of physician group "solvency" than on the side of patients.
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These errant and anonymous physicians are kindly not mentioned, but the East Coast in general - except Washington, DC area and parts of Georgia where Kaiser has outposts (computer portals) - should be concerned about its care.
The Truth - Quite Different
- First, it is important to establish that Dr. Robert Mark Pearl is the son of former dentist (Dr.) Jack B. Pearl as proven by Jack Pearl's 1994 Condo paper [Exhibit M], Will (public record Florida) [Exhibit N], second Condo paper of 1999 [Exhibit O], Jack Pearl's Obituary for death in 1/25/2004+death certificate+funeral-chapel [Exhibit Pa, Pb, and Pc], Karen Pearl's 3/04 Estate Executor type paper [Exhibit Q], and Robert Pearl's Disclaimer (signed in 2004 and a public record - [Exhibit R] - with correct home address12 in Los Gatos);
a.
His father
died after delayed injuries from an auto accident
and delayed recovery [see
successful Pearl Estate law suit against Blanche Groswald for the
accident - Exhibit S];
"It is
alleged that said
motor vehicle accident was the proximate cause of the death of JACK V.
PEARL. who died on January 24th, 2004"
- this does not sound
like a
sudden sepsis in the family residence while visiting Dr. Robert M.
Pearl and found in the living room, in the morning, in any state;
2. The death
certificate - meant in this age of terrorists to be hard to read -
specifies that he was a resident of "Manor Care Nursing Home" in
"Boynton Beach" within the county of "Palm Beach" - making travel to
California less likely than in his final days;
3. The cause
of death
is not seen but could easily be discovered by the Medical Board of
California faxing to the Palm Beach Office of Vital Statistics; if the
Suit against Ms. Groswald
was
truthful, the cause of delayed death should relate to the
motor vehicle accident; [I doubt sepsis at his son's home.]
4. Dr. Pearl would have known all this as a son, physician, and second in line to Karen as executor.
4. Dr. Pearl would have known all this as a son, physician, and second in line to Karen as executor.
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12 One of the reason rural physician often preserve medical ethics is that they have to be ready to meet their patients in the grocery store. Permanente physicians immediately become unlisted in the phone book and when they retire - as Dr. Coble did as Physician-in-Charge in Fresno in about 1998 - they are made to look like they disappear to the coast. The goal is not to find them easily. [I have always been listed in the phone book wherever I practice.] Dr. Coble ended up not on "the Coast" but in Sacramento Kaiser. [In another case they lost an MD - but he was only on the other side of the Bay - still in Kaiser.] The need to make Kaiser physicians transparent even to their home is that when they withhold care the pain and suffering moves into the patient's home - affecting the whole family. We are supposed to be a country where no group lords over any other. Medical knowledge is a privilege - and perhaps medical education is half supported by taxes anyway.
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This lie about circumstances of death alone should be grounds for a California Medical Board license hearing because this story has been compounded by him to so many people and for such self serving purposes. It is out there in cyberspace - influencing people to join Kaiser, encouraging the nation to go digital, and diminishing the outrage over the real mistakes in the South Bay. There is no apology that can ever fit distribution of the lie to bring it back or start over.
This whole story got a brand new life in January 11, 2008 when the Silicon Valley Business Journal (author Sara Solobitch) printed [See Exhibit E] the following:
"Ask
anyone
at The Permanente Medical Group about Dr. Robert Pearl and they'll tell
you their CEO eats, drinks and breathes Kaiser Permanente.
"So much so that even an account of his father's final illness - hundreds of miles away from the closest Kaiser facility - becomes an apocryphal tale in praise of Kaiser.
"The 83-year-old Jack Pearl was a five-day-a-week golfer, a snowbird who shuttled back and forth between New York and Florida ... "
"When I got back from the funeral I put all his information into the [Kaiser] computer system ... And there was, among the list of all the things he should have had: No.7 The pneumococcal vaccine."
"So much so that even an account of his father's final illness - hundreds of miles away from the closest Kaiser facility - becomes an apocryphal tale in praise of Kaiser.
"The 83-year-old Jack Pearl was a five-day-a-week golfer, a snowbird who shuttled back and forth between New York and Florida ... "
"When I got back from the funeral I put all his information into the [Kaiser] computer system ... And there was, among the list of all the things he should have had: No.7 The pneumococcal vaccine."
It is clear that the reporter was interviewing Dr. Pearl and his picture appears near the headline. Part of his motivation at Kaiser is related to the [supposed] unnecessary death of his father:
"It's
a good
chance he would have been alive if he'd been a member of Kaiser
Permanente," said Pearl, not missing a beat. "And that drives me."
If a lie drives him, millions of patients across the country are at risk. And each time he lies and gets away with it, it becomes easier.
He claims no organizational chart - though in Kaiser literature the hierarchy from frontline physician - to physician in charge - etc. is quite clear when pieced together. My ER boss never had any doubt Dr. Pearl was right at the top.
The
author
had her own doubts: "This
is a little disingenuous for a man who is widely perceived to be one of
the most powerful physician leaders in the country."
Note that the physician head of the Permanente Federation is not mentioned as his boss. Dr. Pearl is clearly running the show and this giant HMO hoping to be the model for the future care of 300 million Americans, 60 million in England, and so forth around the globe. Chinese connections are plentiful- starting with the questionable groundwater going into Watson Pharmaceutical products in Southern China (the owners being the military of China) - FDA warning available.
[Later the 2008 article author (innocently) adds the lie about safety at Kaiser for heart attack patients not aware of the purposeful flaws in the state methodogy - those hospital inpatients patients who could be talked out of critical care were listed as "Dead at the [prehospital] scene" if they died.13 There are so many lies pouring out - it is a target rich field from which to select some examples.]
Summary of Lies in Order of Importance
The lie above is sufficiently outrageous to be tried on its own by the Board. But the Board needs to understand that there is a whole culture of lying that is occurring within this giant HMO and it occurs with Dr. Pearl in charge.14 And this HMO is now identified with the State of California in many ways - headquarters, support of Governor's pet projects, $3 billion in tax free bonds, 75% of its total membership, 100% ownership of all distant health plans in Oakland, etc. [This very public lie should make the California Medical Board reconsider the number and type of medical experts used by the Board at this time - disproportionately Permanente partners-for-life.15]
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13 I found this when looking through all the materials like the prepublication responses; Mount Diablo Hospital pointed it out. The state "Outcomes" office has promised to recheck their methodology in the future. Too late -this lie has worked its way into Kaiser ads and press releases.
14 Kaiser is expert at the game of who is in charge - like the "who's on first base" comedy? Mr. Halvorson just celebrated his fifth year at Kaiser. Dr. Crosson was just replaced by Dr. Cochran from Denver as President of the Permanente Federation. But the lead physician of the largest and richest Permanente physician group (TPMG) is Dr. Pearl. After years of study, I put him as really in charge. Just ask him how many Kaiser Plan/Hospitals Board meetings he has ever missed - and then check his answer by the minutes.
15 Permanente partners who vest in five year intervals can retire at some 60% of salary for life after working twenty years without the need to wait until they are 65. The formula is on Permanente recruiting websites and shows up in California bankruptcy court. What is not shown is that the physicians must also use Kaiser for life for their health care, they cannot work anywhere else, and their whole pension can be voted away if they do not go along with Kaiser's expansion and legal defences. This has been well documented by physician whistleblowers. For those wishing to leave, Permanente uses sham peer review to try to both keep their - all money reverting to Permanente - retirement monies and to damage future MD eye witness or expert witnesses. This is much like the book/movie The Firm - no one leaves intact unless they leave with Permanente blessing, e. g. for Illness - one recent one In Fresno for cancer.
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1. Lie - Kaiser Permanente is
"nonprofit" - "Kaiser Permanente" is not
really a registered business entity but only a "medical care program"
as a beam convergence between three units. One of those units - the one
in control (e.g. per slides they use in England) is the physician unit
which is registered with the state as being for profit.16
To call KP "non-profit" in many locations and every press release is to
fool the public. The public believes that a "non-profit" is something
trustable and motivated toward higher goals like the Red
Cross. The physicians try to pretend they are only salaried -like the
MDs at the Mayo Clinic - but they have admitted17
that their "salary" is only part of their full partnership draw (so
just another lie).
And
while
"Kaiser Permanente" is a crafted ad "tagline" ("ad tagline" is a Kaiser
term featured in the Permanente Journal) to mix the two names together
- government falling for it as well all too often - the public is
poorly served by this ad game. The Kaiser Plan made over $2 billion in
profit ("net income") in 2007; and that will as always be split between
the hospitals and the physicians. That profit is the care not given to
patients - as explained to President Nixon indirectly by the Kaiser CEO
and featured very clearly in the movie SICKO.
2. Lie - Permanente is "Independent"
of Kaiser - When J. D. Kleinke wrote an article in Health
Affairs Volume 24, Number 2 - George K. York and Robert M. Pearl
answered back with a two paragraph letter stating that the Permanente
groups are "independent" of Kaiser since they have different boards. In
contrast, a jury in 2006 decided after reviewing massive amounts of
evidence in Southern California that they operate as one business unit
- the whistle blowing physicians then having employee rights like not
being dismissed for speaking truthfully (e.g. about the Kaiser
endocrinologist pedophile). In 2007 the Appeals Court upheld the jury's
right to make that decision - one business for purposes of physician
whistle blowing rights. Also,
the top executive committee at the HMO is co-chaired by the head
Permanente Federation physician and the Kaiser Plan CEO; these two
(with Dr. "Robbie" Pearl nearby) handle all material going to the
Kaiser Plan/Hospitals Board and all decisions coming back from it.
They say so in their own materials online. In fact, every physician
leader is supposed to also be an accountant in spirit. The Founder
physician stated everyone should keep track of their "wallets"; Dr.
Francis J. Crosson echoed that quote on his recent departure article at
the head of the Permanente Federation.
3. Lie - The "In the Hands of
Doctors" Tagline - This was a carefully orchestrated
tagline some years back18
(See Permanente Journal articles on ad strategies) also trying to paint
the physicians as independent of Kaiser Plan control. However, Kaiser
lost this claim and abandoned the slogan - within the
successful suit
Olsen/Victa v. Kaiser. The actual lawsuit conclusion was buried deep -
which is against public policy19 (in my
opinion)as the two parties
(plaintiffs and Kaiser) all but kissed in synchronized press releases.
I was a background expert (paid $25,000 over five months) and told to
never discuss the matter; that would not be consistent with public
policy interest (so I have ignored the potential threat). You, as the
Medical Board of California, need to obtain and read the details of
this
case and the settlement
outcome; it should not be buried from the
Consumer Group looking out for patients. If you look hard enough inside
KP, you will find Dr. Pearl agreeing to the false tagline - "in the
hands of doctors" - either orally (the legal charge of conspiracy
allows hearsay) or in writing.
4. Lie - The Care of His Family is what patients can expect - Dr. Pearl asserts that his two children were born at Kaiser; this is true since care must be done at Kaiser both during employment and after retirement.20 It is built into the retirement gold - you must keep yourself and your family dependent on Kaiser for your health care. Otherwise you can lose the pension valued as that of a millionaire.21 But there is no chance that Dr. Pearl's family gets the same care as the general Kaiser enrollee - the later actually called "external customers" inside Kaiser (Kaiser drawing of patients as sad sacks available if needed).
5. Lie - CV of Dr. Pearl [Exhibit T] states Published "100 articles" [Exhibit U] in Medical Journals - Dr. Pearl did publish many medical "articles" but they would most likely add up to below 50. The public would not normally think a two paragraph economic letter critiquing another article would be counted in such a listing. Nor would they count articles about who will do well economically among doctors in the future - that is just the recruiting of more physicians.22 Dr. Pearl should actually count only those articles which were on medical care topics and were of a respectable length - an article number below 50.
This
is just a sampling of the goal of Kaiser to fool the public. Perhaps as
the renal transplant disaster under the leadership of Dr. Pearl gets
played out in court, more of the "Permanente culture" will become
exposed to the public. The real key is that the Hippocratic Oath as
symbolized by the white coat they still wear is (within this culture)
in constant competition with the "group ethic" - the physician
fraternity looking for high lifestyle retirement.23
Those wishing to
understand all this need only ask me to explain (online) The Permanente
Medicine Map. The "group ethic" is the "wind" that drives the
Permanente navy, the later promoting very clearly the illegal
"Permanente-patient relationship."4. Lie - The Care of His Family is what patients can expect - Dr. Pearl asserts that his two children were born at Kaiser; this is true since care must be done at Kaiser both during employment and after retirement.20 It is built into the retirement gold - you must keep yourself and your family dependent on Kaiser for your health care. Otherwise you can lose the pension valued as that of a millionaire.21 But there is no chance that Dr. Pearl's family gets the same care as the general Kaiser enrollee - the later actually called "external customers" inside Kaiser (Kaiser drawing of patients as sad sacks available if needed).
5. Lie - CV of Dr. Pearl [Exhibit T] states Published "100 articles" [Exhibit U] in Medical Journals - Dr. Pearl did publish many medical "articles" but they would most likely add up to below 50. The public would not normally think a two paragraph economic letter critiquing another article would be counted in such a listing. Nor would they count articles about who will do well economically among doctors in the future - that is just the recruiting of more physicians.22 Dr. Pearl should actually count only those articles which were on medical care topics and were of a respectable length - an article number below 50.
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16 The original TPMG, Inc. formation papers filed with the state are available at any time in paper or electronic form.
17 In 1984 Medicare was asked to write up a booklet about all physician incomes. Permanente told the truth and it was written clearly into the bound book that the salary is only part of the "draw" with profit added in at the end of the year. They don't deny all this - they just hope silence is on their side. Carefully crafted ads will carry the needed messages.
18 It still shows up on the radio, e.g. with the Breast Cancer Awareness Week promotion for Kaiser in 2007 - probably run as a public service announcement by the radio show but really served as a free ad for Kaiser.
19 The Ford roll-overs scandal was also buried for a while. The courts are rethinking how much corporate danger is being buried in settlements.
20 If you look for it carefully online under MD recruiting benefits, you will find a Colorado Permanente physician joking about how scary this is.
21 This valuation was offered in court by a bankruptcy trustee in Los Angeles - and can be found in the San Francisco Court papers at the Appeals court level. Kaiser was proud never to have turned over an exact figure on the issue. Over $15,000 a month for life is the key to Kaiser retirement for docs and high executives! - no bad for the art of withholding care.
22 Kaiser lies about getting top applicants and turning away 90% by counting the multiple location medical school applicants for the Stanford-Kaiser residencies. The reality is that many Kaiser physicians come from those J1 Visa immigrants who are relocation from New York and New Jersey where they entered the US from other countries by way of residencies. The idea of a free home down payment at to $100,000, a good paying job with 25% benefits, and a chance at millions in retirement is tempting. The only problem is changing to a different ethic. Note that few of these source countries have Hippocrates featured as a model or use the white coat ceremony; all of these physicians, of course, wear white coats as they come into the presence of the patient.
23 As Permanente has gotten more into this process they invite the new physicians and their spouses to a retreat (oral discussion only - no papers, tapes, or notes to be taken) to explain what is possible if the MD can just get into the Permanente groove. Internally, to be "Kaiser-ized" as an MD is a verb - it is the transition from the medical to the business ethic. Most of the MDs used to tell me - when I worked inside of Kaiser - that they were not really Kaiser physicians but only there to get to the next vesting level.
---------------------------------------------
Attack the Messenger
The response that the Medical Board of California can expect from this complaint and careful documentation (many exhibits and a huge backup library) is that they should discount me as a source of any information because:
1. I have a
permanent
tatoo from a MBC action wherein the word "incompetent" was sustained by
an administrative judge [someday I will revisit this whole process in
which no physician representative of the Board ever talked to me];
2. The judge ordered a psychiatric exam of me [but Kaiser never noticed that I passed with flying colors - not even needing any psychometric testing24];
2. The judge ordered a psychiatric exam of me [but Kaiser never noticed that I passed with flying colors - not even needing any psychometric testing24];
3. That I
seem to go
around the country and criticize Kaiser [silence from the Medical Board
of California and other boards does keep me active];
4. My statements about Kaiser are inflammatory - like "killing fields," "morphine hotel," etc. - and are thus not possibly true [one must be complimentary to the HMO in order to be credentialed before judges so as to be neutral enough to point out its few flaws25];
5. I am only an emergency physician in rural settings, so I should hardly be expressing myself on an organization that is largely urban.26
------------------------------------------------4. My statements about Kaiser are inflammatory - like "killing fields," "morphine hotel," etc. - and are thus not possibly true [one must be complimentary to the HMO in order to be credentialed before judges so as to be neutral enough to point out its few flaws25];
5. I am only an emergency physician in rural settings, so I should hardly be expressing myself on an organization that is largely urban.26
24 I did mention bomb threats in Guam. But since the threat came through the hospital (GMH) and the FBI was informed, it was hard to make this out to be my delusion. I went on about my way setting up the paramedic system in Guam that saves lives every week.
25 Congress, in the debate about the Patient Bill of Rights, focused within its public chambers and before the full media on a child in Atlanta who lost his arms and legs due to a Kaiser Plan dispatcher who forced his parents to drive far to a Kaiser Hospital for care as sepsis damaged him. I suppose Congress was being too strong and should have complimented Kaiser before focusing on this mishap.
26 Kaiser is all over California but is mostly urban centered by zip codes in other states - DC area, Denver, Atlanta, etc. (though the national Kaiser maps look like full states are covered - another purposeful misrepresentation). The purpose of this is to permit tertiary "gatekeeping" not possible in the rural setting. I stay rural partly to make sure that my income is not beholding to the urban HMOs. It also gives me time to write letters like this.
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You can either discount the messenger or study the message. I consider myself only a tour guide.
Conclusion
The primary lie Dr. Pearl told in many settings was that his father died and was found in the living room in California - not in Florida. The cause of death was explained by Dr. Pearl to be sepsis of streptococcus pneumonea due to the lack of protection from a missing pneumovax immunization shot. Dr. Robert M. Pearl took small papers found in his father's "pockets" and fed them into the Kaiser supercomputer to get the answer - a missing immunization on the East Coast. The implication is that Kaiser computer could save many more lives if used everywhere. But there is little chance that the story is even slightly true. The Pearl estate through his sister sued and won - delayed death from an auto accident. Is this okay for MDs in California?
Sincerely,
Charles Phillips, MD, FACEP
PS - I have recently discovered that the Medical Board does not keep files that they close. So one option you have is to close this letter and quickly destroy it. If you do so, the only logical step I can take is to make sure those who oversee the Board also get a copy. If you condone lying, then you should do so on the record. After all, you represent the Governor, and he represents the People.
Copies - to be decided by me in the future
INDEX OF EXHIBITS MENTIONED IN THE ABOVE DOCUMENT