Emergency Medical Aid

Kudos to Drs. Marie Kuffner and Loren Johnson for their well-reasoned response (“Doctors Are Saying ‘Enough’ for a Reason,” Commentary, June 11) to your June 2 article on problems of emergency backup call (“ER Patients Lose in Specialists’ Rebellion”).

Simply put, if health plans advertise that they offer a full range of specialty services, those plans are obliged to ensure that a panel of physicians providing those services is, in fact, available. Otherwise, they must compensate non-contracted specialists who do come in to treat the plans’ patients in an emergency. In the case cited in the June 2 article, the plan apparently had not arranged such a panel. For too long some health plans have relied on the knowledge that physicians will almost always help those in need and then retroactively denied any payment for that help.

Our task force found that physicians rarely refuse to treat patients who are on Medi-Cal or have no insurance. Many, however, have become reluctant to see subscribers of plans that have repeatedly denied payment for services already verbally approved. We know of no other profession whose members routinely provide such services with virtually no hope of compensation.

GERALD I. SCHIFF MD

Co-chair, Emergency On-Call

Task Force

FRANCINE HANBERG MD

Vice President

L.A. County Medical Assn.