A patient-friendly policy change meant to improve access to urgent care for some Kaiser Permanente enrollees apparently has backfired.
The HMO's Permanente Federation, the organization that links the 12 Permanente medical groups, was sued by one of its own physicians for allegedly triple-booking patients for after-hours urgent-care appointments at two Northern California facilities.
The suit followed a switch from a drop-in urgent-care system to an appointment-based system that was meant to improve access, Kaiser said.
Joseph Flores, M.D., joined six Kaiser HMO enrollees in a lawsuit filed late last month in California Superior Court in Sacramento County. It seeks to bar "stacking" of patients for urgent care at Kaiser's Roseville and Sacramento facilities.
According to the lawsuit, up to four patients were scheduled for one 15-minute appointment. The result, the suit said, is patients are seen too briefly for adequate diagnosis and treatment. Some patients leave in frustration, not seen by anyone.
The suit said the practice of scheduling multiple patients for one appointment time was implemented in the two facilities as a cost-cutting "test" for possible implementation at other Kaiser facilities.
According to the suit, Flores complained to Kaiser orally and in writing. When he did not receive a satisfactory response he wrote to the California Department of Corporations, which didn't intervene.
The suit asserts the practice violates California's law that licenses HMOs and constitutes unfair competition or unlawful business practice under state law.
A Kaiser spokeswoman said the company would not discuss the suit's specifics. She said Kaiser has more than 450,000 enrollees and 650 physicians in the Sacramento area.
She said the appointment-based scheduling was implemented about two years ago at the Roseville campus and one year ago in Sacramento.
In a statement last week, Edward Green, M.D., chief physician at the Roseville campus, said Kaiser does not double-book patients for routine appointments.
"In our after-hours urgent-care clinics it is sometimes difficult to accurately predict demand on a given evening or weekend," he said. "Occasionally, the patient demand is greater than expected, and a physician may need to see more patients than initially scheduled."
Scheduling appointments for urgent care is unusual, said Gary Zimbric, M.D., medical director at Wausau (Wis.) Clinic, who works on patient issues for the American Medical Group Association.
Zimbric said appointment-based scheduling could soften the peaks and valleys typical of urgent care, although it hasn't caught on.