Word: physicians
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...Adrian Rubin, who agreed with the Greenville doctor that Hunter needed a new liver but who also recognized that insurance was very much a factor. Rubin consulted with the hospital's financial staff, which confirmed that MUSC did not have a liver-transplant contract with Hunter's carrier, Physician's Health Plan. But, Rubin was told, Duke, where he knew the liver people, did have a PHP contract. So the physician recommended that Hunter go there. Rubin placed a call to Duke hepatologist James Trotter, explaining that he had a seriously ill transplant candidate and that he understood that...
...million, if complications arose. The precipitating error apparently took place in the back offices of MUSC in Charleston, where someone misidentified Duke as a PHP contractor. One possibility is that PHP's contract with Duke to do bone-marrow transplants was misconstrued as a liver contract. Another is that Physician's Health Plan was confused with another provider that is also sometimes referred to as PHP: Partners National Health Plan, a North Carolina insurer that does have a liver-transplant contract with Duke. "It's an alphabet soup out there," complains Karyn Bowie, director of managed care at MUSC...
Strauss settles back in the Piedmont sunshine. In a chair nearby, her husband sits silently. "I knew I wasn't going to curl up and die," she says. When she first learned she had cancer, her son, who is a physician, was worried that his mother would not live to see her first grandchild, not yet born at the time...
...these kids, who range in age from five weeks to 15 years, this clinic represents their last hope. "They came in here with zero survival chances," says a physician. But thanks to a new treatment that swaps good cells for bad, the 16 kids here now have at least a fifty-fifty chance of survival...
...Medicine has improved, and...what you're able to do as a physician has changed with the economics of health care," she said...