Phone clerks rewarded for limiting MD visits

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Bonuses for keeping patient calls brief

Toronto Star

Telephone clerks at California’s largest Health Maintenance Organizations got bonuses for keeping calls with patients brief and limiting the number of doctor visits they agreed to set up.

Oakland-based Kaiser Permanente offered the bonuses at three northern California call centres from January 2000 to December 2001, after which the extra pay was discontinued, company spokesman Jim Anderson said.

“At the end of the year they looked at, ‘Were we doing a better job for members than when we started it?’ The thought was no,” Anderson said yesterday. “The whole purpose of this was designed to help serve members better.”

The California Nurses Association, the union representing Kaiser‘s registered nurses, derided the program as deceitful and harmful to patients with serious medical problems.

“We characterize them as morbidity bonuses,” said Jim Ryder, director of the union’s Kaiser Permanente division. “Patients don’t understand they’re talking to a high school graduate with no nursing background.”

The clerks, who generally have little to no medical training, take calls from customers wanting to set up doctor appointments or asking simple medical questions.

Cash bonuses were paid to those who made appointments for fewer than 35 percent of callers and spent less than an average of three minutes, 45 seconds on the phone with each patient. Clerks were also encouraged to transfer fewer than 50 percent of the calls to registered nurses for further evaluation.

Anderson said clerks received between 2 percent and 4 percent of their salaries as bonuses.

Jamie Court, who heads the watchdog group The Foundation for Taxpayer and Consumer Rights, condemned the bonus program.

“Patients get lost in this telephone hell, but these aren’t people complaining about a credit card bill,” Court said. “These are people with some life-threatening illness, and if even one person falls through the cracks, the system is broken.”

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