What's Behind San Francisco's Doctor Spat?

Brown & Toland, UCSF spar for patients

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    NEWSLETTERS

    TK
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    Some insurance patients might have a harder time getting access to UCSF doctors, thanks to a spat between physician groups.

    It's not often that doctors beg for your business. So why are UCSF and Brown & Toland flooding the airwaves with ads?

    The two physician groups are just some of the Byzantine factions that make up the local healthcare scene. Physician groups represent doctors working at various hospitals, clinics, and private practices, which in turn negotiate rates with insurers.

    Beginning January 1, doctors at the University of California at San Francisco will begin contracting with Hill Physicians instead of Brown & Toland. Brown patients will need authorization to see a specialist at UCSF, while Hill patients will have unrestricted access.

    Some ads run by UCSF suggest that Brown & Toland patients with, say, cancer won't have access to doctors at that facility, with its well-known oncology clinic.

    "I think the ads are disturbing, says Dr. Neil Birnbaum, CEO of Brown & Toland. "It's unfortunate. They are frightening patients and in some cases the content is just wrong and what patients are being told by individuals at UCSF is wrong."

    Birnbaum says the commercials are scare tactics to make patients believe they won't be able to see UCSF specialists if they stick with Brown & Toland -- something that's simply not true, he says: "Even if there is not a contract we will send those patients who need to go to UCSF to UCSF."

    They'll require an authorization, however. UCSF's Dr. Sam Hawgood is not sure how easy that will be. He says the only way to ensure access to a UCSF specialist is to choose a Hill physician.

    Easier said than done, since many people receive insurance through their employer and don't have a say in which insurer they get, or which business deals that insurer strikes with physician groups.

    The change affects HMO patients receiving healthcare through Aetna, Anthem Blue Cross, Blue Shield, Cigna, HealthNet, or PacifiCare.

    Those who have Brown & Toland doctors and are curently seeing a UCSF physician for an existing condition can continue seeing that specialist until the end of 2010.

    Both UCSF and Brown & Toland are still hoping to work out a contract agreement, despite the hint of animosity over who broke things off. Both Birnbaum and Hawgood blame the other's organization for the split.