Kaiser PR Disguised as News: A Physician Responds
A physician who formally worked for Kaiser Permanente has written the following letter to Dr. Robert Pearl, the hypemeister CEO of Kaiser Permanente's Northern California region. I hope he will forward it to the Mercury News to underscore the problem with treating a Kaiser press release as news.

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Robert Mark Pearl, MD is perhaps the third most powerful man at Kaiser Permanente. He is the physician CEO of the largest of the for profit medical groups - The Permanente Medical Group (TPMG) of Northern California. He has been one of the chief architects of all of the rationing of care and central control of care going on in Kaiser for the last decade.

Last month numerous medication errors with lethal outcome showed up within his zone of Kaiser - in the South Bay Area near San Francisco. The newspaper showed unusual courage and accuracy in reporting the episodes. It was echoed by another story - that Kaiser has found a way to keep physician names in losing arbitrations from being reported to the Medical Board (both in California and in Oregon).

Kaiser was bound to develop a reply, particularly one developed by their Brand Alert committee since such information leaks were counter to the image in the Thrive ad campaign costing them $40,000,000 a year just to keep enrollment flat. All that was necessary was to come out with an infomercial that might get printed as if a news story about Kaiser great safety campaign.

And so Dr. Robert Pearl was presented as if the head of Kaiser Permanente and with a victim story of his own. Victim-in-chief lost his father two years ago because the latter man was not given the protective immunization that always follows a splenectomy. This Pneumovax shot helps prevent pneumococcal pneumonia, an illness that the spleen can often control if present and functioning. The shot is given to anyone who either has no spleen or whose spleen is non-functional.

Dr. Pearl is a plastic surgeon who would have known his father's own surgical history unless the two were all but non-speaking. As a surgical resident at Stanford - after graduating from Yale Medical School in 1972 - he would have learned that everyone after a splenectomy have to have the shot. In fact, hospitals would comb their records to find patients from the past needing such a shot just to avoid death and law suits.

Thus had his father been missing the primary pneumonia shot or the booster, the man responsible for the error would be his son Robert Mark Pearl, MD or "Robbie" as he is known in the hallways of KP. He would have had to insist that his father be protected. His father could have refused.

To blame this supposed mistake on some anonymous private medical system somewhere in the country so as to make Kaiser Permanente look like a haven for safety is such a huge spin on the truth. It matches his other ads on the radio suggesting that the elderly who join Kaiser will get the care enjoyed by Dr. Pearl's own family.

My own challenge to Dr. Pearl would be to prove that his father had such a final illness as overwhelming pneumococcal pneumonia at the end at that he, Dr. Pearl, would have only learned of the prevention right after. I suspect that his father had no such final illness and that this story is totally manufactured, like most of the Kaiser spin out there.

All of this demeans the patients who experienced real error and deflects the efforts to find out why Kaiser promotes error. It is all about speeding up medicine and treating patients as "external customers" who are basically the "worried well" overutilizing Kaiser services. The business model of medicine is what a Mayo Clinic physician called "the monstrous hybrid"; this is not so different from that of the Supreme Court justice who called it the "creature of Congress."

Charles Phillips, MD