The Society Read Free Page A

pressure’s on all of us now all the time. They tell you that the average surgeon gets his gallbladder patients out of the hospital on the first post-op day, or even the day of the procedure. You know darn well that if you keep yours in an extra day or two, you’re going to be right down on the HMOs’ list. They don’t ignore these things.”
    “Just the same,” Katz said wearily, “thanks for saving my bacon.” He returned to his patient. “Mr. Garfield, I’m going to wait for your wife to get up here, then we have to talk.”
     
    “I’ve never seen him so glum,” Susan said, as they headed off to see the first of her patients.
    As the sole woman in the group, Susan had proclaimed herself the mother hen, dedicated to keeping Gordo’s weight under control, seeing that Will got enough sleep and met someone special, and insisting that Jim Katz cut back on his many obligations.
    “We more or less grew up with the problems of managed care,” Will said. “Jim’s had to adapt to them. He gets sort of wistful when he talks about the time when you simply diagnosed a surgical problem in a patient, cut it out, and cared for the person until they were ready to go home.”
    “Ah, yes, the good old days before one-size-fits-all medicine. My mom is embroiled in a battle with her HMO right now. She’s got huge fibroids, complete with pain and vaginal bleeding, and her GYN wants to do a hysterectomy.”
    “Makes sense to me.”
    “Me, too, but the evaluators at her HMO say the procedure is unnecessary. What’s more, they performed their magnificent evaluation of her over the phone. No one from her HMO has ever laid eyes or hands on her, but they’re the ones making the decision.”
    Will hoisted himself up haughtily and adopted a dense British accent.
    “I’m not a doctor, but I play one on the phone.”
    “Exactly. So Mom has pain every time she takes a step, and her doctor says the fibroids would make it impossible for him to feel a malignancy if one were there.”
    “Goodness. She still in Idaho?”
    “Forever.”
    “And you never had any desire to go back there to practice?”
    “How can I know I exist if I can’t see myself in store windows when I walk down the street?” Susan’s dark eyes smiled. “Besides, what do I have in common with Demi Moore and all of those other big-name transplants from Hollywood?”
    “You should bring your mom’s case up at the Society meeting Thursday night.”
    “Um . . . the truth is, I hadn’t decided if I was going to go. Will, I appreciate your enthusiasm for the Hippocrates Society, really I do, but after almost a year of going every month, I just haven’t gotten caught up in it. I’m definitely upset with managed-care companies’ policies and regulations and all they’re doing to the way we practice, but I just haven’t been able to get as . . . as fired up as the rest of you, even with my mom’s recent problems. You know me. I’m pretty reserved about most things—not shy like some people think, but not that outspoken, either. And excuse me for saying so, but you people are fanatics.”
    Will laughed.
    “Hey, now, I wouldn’t go that far. How about committed?”
    “If that makes you more comfortable.”
    “Listen, Suze, we need every body we can get at these meetings. There were over a hundred docs there last time. A hundred! The papers are really starting to take notice.”
    “Will, I’m on two committees in the hospital and a couple at church. The people on the desk at my gym don’t know who I am, and I’m afraid my boyfriend may be headed there, too.”
    “I understand. Just do your best. I may tell your mom’s story anyway.”
    “You have my permission.”
    “These companies have ripped the heart out of medicine, Susan. They have to be stopped.”
    “You just be careful not to rile them up too much. You wouldn’t be the first doctor they’ve squashed.”
    “I’d like to see them try,” Will said.

CHAPTER 2
    Ashford was a bedroom