Heather Dubrow values the relationships she's had with medical professionals. That's why it upsets her when health-care administrators make these difficult to maintain.
"When a doctor leaves UW Hospital, they do not release - indeed, they conceal - where the doctor has gone," says Dubrow, a professor of English at the UW-Madison. "This reflects more concern with keeping patients within the UW system than maintaining the personal relationships they've established with their patients."
Dubrow says continuity of care is important for medical as well as personal reasons. Her father, a gynecologist, once noticed a subtle difference while examining a longtime patient's uterus; he ordered more tests, which led to an early diagnosis of cancer.
In 2000, Dubrow learned by letter that a UW specialist with whom she had a "long and positive" relationship had left to practice in another Wisconsin community. No further information was provided.
The following year, another specialist Dubrow was seeing also left the UW fold. She got a call rescheduling her appointment - with another doctor. "The decision to reschedule was presented as a fait accompli, not an option."
Dubrow said she wanted to stay with her physician, and was initially told that the UW had no idea where this person had gone. Dubrow "vigorously protested," and the UW eventually revealed the physician's new location - so close that it was not a inconvenience.
A UW official responding to Dubrow's letter of protest over these events insisted that patients are routinely told where doctors who leave the UW have gone, but that in the cases she cited "the providers who left never officially told us where they were going to practice." She found this hard to believe.
Two of Dubrow's former doctors back her account. One, speaking on condition of anonymity, says the UW prevented him from sending out a letter telling patients his new whereabouts and would not provide this information to those who asked. The other, Dr. Julie Schurr, says she was not allowed to tell patients about her new practice in Fitchburg and that patients had a hard time learning this from the UW.
Recently, Dubrow says this happened again: She learned that a doctor she had seen left the UW, and asked the hospital where he'd gone. The receptionist, she says, told her this information could not be released.
Lisa Burnett, a spokeswoman for UW Hospital, says officials she consulted were "very dismayed" to hear of such incidents, "since the policy and the practice is to always tell patients when the provider leaves and to give them options for care. If they want to follow a provider out of the system and if that provider has told us where he or she is going, we do tell the patient."
The hospital, says Burnett, agrees that continuity of care is important, and respects patients' wishes in this regard. She says if a patient did have difficulty learning where a provider has gone, it's because the provider did not tell the hospital ("that has happened on a couple of recent occasions") or a regrettable mistake was made. "We do have a pretty large operation," she notes.
At any rate, this is not an issue that concerns the UW alone. Dubrow's ophthalmologist, Dr. Michael Shapiro, tells Isthmus that when he and his partner began their own practice in the mid-1990s, their former employer "wouldn't tell people where we were" and in some cases "told people we had left the country."
"I agree with Ms. Dubrow," says Shapiro. "It's not right. They're taking away the right of the patient to choose their provider."
That's especially ironic, given that this so-called right of choice tops the list of things defenders of the health-care status quo claim would be jeopardized by any move to universal coverage.
Undermining the PFC
It's hard to imagine a less user-friendly public body than the Madison Police and Fire Commission. But the PFC's longtime attorney, Scott Herrick, says that's what may be coming down the pike.
The Senate version of the state budget includes language, which Herrick thinks will make it into the final bill, calling for sweeping change in how PFCs operate. "It subordinates the statutory disciplinary process to collective bargaining," he says. (For his analysis, see this column at TheDailyPage.com.)
Individual unions could negotiate to make disciplinary actions subject to arbitration, rather than - or in addition to - PFC proceedings.
Herrick also thinks the changes might end or greatly complicate the ability of citizens - as opposed to police chiefs - to initiate PFC complaints. Currently, such complaints are permitted, although the Madison PFC advises citizens to get a lawyer at their own expense and then virtually always sides against them.
If the new language passes, officers facing discipline may have three or more kicks at the cat. They can have their case go to the PFC, which can take months or even years. Then, if they don't like the result, they can bring the matter to arbitration. And if they don't like that result, they can insist on court review - not just in circuit court, as is currently permitted, but all the way to the state supreme court. In the meantime, suspended officers may continue to receive full pay and benefits.
"This attacks both the front end and back end of the PFC process," says Herrick, who predicts that passage of these changes will spur "years of litigation."
Sounds like a lawyer's dream.
Heard it through the gripe vine
Since it was launched in December 2005, the city of Madison's "Report-a-Problem" website has gotten more than 9,000 complaints. The largest single category, no surprise, is for disputing parking tickets (good luck with that). Another heavily used category is "general complaints."
About 500 complaints have come in this portal since the start of this year. Most report problems for which there are clearly other categories, like for unshoveled sidewalks, unplowed streets, uncollected trash, overgrown weeds, unsightly graffiti.
But among the remaining general complaints are a few doozies. Our favorite five:
1. [From "Anonymous"]: "Why are homosexuals allowed to lurk, stalk, and stare at other men at Olin Park? It appears something is going on in the tree lined forest in back of Olin-Turville complex.... The Madison police should stop these people from taking over the park."
2. "Can you please send me a pen with your company name/logo on it? Thanks, Ted Politza, 8 W. Manheim Dr., Middletown, DE 19709."
3. "We would appreciate a little heads up the next time you folks flush the sewer. Why is the sewer being flushed? I just finished cleaning a bathroom from floor to ceiling because the toilet exploded. Please advise residents, so we'll be better prepared the next time round. I do not enjoy mopping up stinky toilet water. Have some consideration."
4. "I noticed that you sell gift certificates for park purposes - do you also sell gift certificates for payment of utility bills?"
5. "This is a really great service. Very easy to use and responsive. Keep up the good work."
Thank goodness for experts
The subhead of the Wisconsin State Journal's Aug. 16 story about a disturbing new fad: "Experts say jump from Monona Terrace rooftop into Lake Monona is dangerous."