Cleveland Doctor Terminated from Hospital for Failing to Meet Revenue Targets

Today was Dr. George Randt's last day taking care of patients in Cleveland, Ohio. They cried, and he cried.

Dr. Randt is a primary care physician who has taken care of many patients, many of whom are in their 70s and 80s. His contract was terminated by St. John's Hospital. He says, "I was terminated because of lack of productivity. We weren't seeing enough patients."

His termination illustrates how patients have become a means to an end, and that end is the financial bottom line.

According to Dr. Randt, the chief financial officer of the hospital told a medical staff meeting a few months ago that if all the doctors could admit one more Medicare patient a month, the hospital would meet its revenue targets. "This suggests we should go out and commit fraud," Dr. Randt said.

"It's unconscionable," Dr. Randt continued. "I try to keep patients out of the hospital who don't need to be there."

He recalled two of his patients who doctors wanted to admit to the hospital. Dr. Randt intervened. Because he knew the patients' medical histories and took the time to talk to them, he helped them avoid the treatment trap and being admitted to the hospital.

"Patients are being overtested and overtreated," he said of patients. "It only creates more anxiety for them."

Dr. Randt was informed on March 31, 2010 that his contract to provide care to 1,000 of his patients, would end today. A partner in his practice who takes care of 1,500 patients, is also being terminated.

"I received bonuses in December 2008 and 2009," Dr. Randt says. "This suggests that we were generating a profit. I guess it wasn't enough."

On Sunday, May 2, a rally is being held at 29000 Center Ridge Road, Westlake, Ohio. Patients, family members, former staff members and others will speak at the rally.

"People should be out in the street protesting about the adverse effects of medicine driven by money," he said.

Patients ARE Saying No: Response to David Leonhardt's the "Power of No"

David Leonhardt's NYT article today asks, "How can we learn to say no?" to unnecessary medical treatment. Here's the unvarnished truth. People already are saying no. In droves. They are finding medically appropriate, less invasive and costly approaches.

Last month, at a National Quality Forum meeting, I asked the health care leaders assembled, "Have you said "no" to treatment recommendations you thought were unnecessary? About one-third of the hands went up. This is a savvy group that understands the "power of no".

Here's a few true stories. At an AARP meeting a few months ago in Princeton, New Jersey, a woman described how her doctor said she needed an angioplasty. A second opinion revealed she didn't need it. The same was true for a woman who was told she needed a cardiac catheterization. The list goes on all over the country. Policy makers are not immune. A legislator was suprised to learn he needed a hernia operation. A second opinion revealed he was just fine.

A large swath of the public is more enlightened than policy makers and pundits know. Let's bring them into the policy dialogue. They can shed light on a way out of a financially unsustainable health care system while improving quality at the same time. That's a twofer too good to pass up.