Cancer Patients Protest Medical Group’s Policy

Claiming a health care group is forcing out the doctors they trust, about 30 cancer patients and their supporters picketed Tuesday in front of the organization’s Sycamore Drive offices.

The patients--some leaning on canes, one in a wheelchair--waved signs denouncing the Family Health Care Medical Group for replacing two veteran cancer specialists, doctors whom the patients credit with keeping their strained hopes alive.

“We’re already fighting for our lives--we don’t need this,” said Linda Wolfe of Simi Valley, who suffers from multiple myeloma, a bone-marrow disease.

But Dr. Geoffrey L. Graham, Family Health Care’s president and managing partner, said the staffing change would give patients greater access to cutting-edge care.

The firm has brought in two cancer specialists who already have an office in Simi Valley and belong to a new physicians network created by UCLA. That connection will give Simi Valley cancer patients better access to experimental drugs and treatments, Graham said.

“UCLA is, in essence, coming to us,” Graham said.

At the heart of the dispute is the way Family Health Care pays its affiliated physicians. The organization pays doctors a flat rate rather than tying their income to the number of procedures--such as surgeries--performed. The system is common among health maintenance organizations, but substantially different from the way doctors have traditionally been compensated.

Graham said the system is supposed to provide an incentive for doctors to keep their patients well, rather than rewarding them for doing numerous procedures.

“You’re not paid for procedure care, you’re paid for the totality of care,” he said.

Cancer specialists Hany R. Khalil and John Thachil used to work for Family Health Care under the traditional payment system. When management asked them to switch, they balked.

Khalil said the change would have cost him about 30% of his annual income. Even so, he eventually decided to accept the firm’s flat fee.

But Khalil said he refused to go along with another management request--specifying that physicians would have to pay to send their patients to UCLA for care they could not provide. He estimated that the annual cost to him would be about $9,000.

“For $9,000, they’ve thrown out their doctors, they’ve thrown out their patients,” he said.

Graham said he does not know how Khalil arrived at the $9,000 figure, but said the organization’s doctors now pay flat fees to UCLA for the ability to send patients there.

“UCLA needs to be paid for its services,” he said.

The medical group has started referring all new cancer patients to Drs. Harry Menco and Bruce Zietz, who have medical offices in the Sycamore Drive building that was picketed Tuesday. Those patients in the midst of a chemotherapy treatment cycle, Graham said, will be allowed to continue with their current doctor until the cycle is complete.

Patients on the picket line complained that the change was forcing people to leave doctors they trust. Nancy Nagel of Simi Valley used to visit Khalil for her breast cancer, which is now in remission following two mastectomies. Cancer patients, she said, want to continue treatment with physicians they find to be reliable and understanding, such as Khalil.

“You’re faced with something life threatening, you finally get someone you trust, and then they take him away,” she said. “It’s like starting over.”

Although the protesters said they want to see the medical group retain Khalil and Thachil, Graham said the organization’s contractual ties with the pair will end in April, and the group has no plans to rescind its decision.

Khalil said he is unsure how to approach a situation that could cost him many of his patients after 16 years of practice in Simi Valley.

“The patients are the ones who pay us all, and they should decide what’s best,” he said. “I’m a believer that the public--the patients--if they stick [up for] what they want, they’ll get it.”