I am a practicing specialist physician in California.  The empahsis in
my HMO is on two week access to specialist care, and we do usually
provide that.  I believe the primary incentive to providing two week
initial access to specialists is based on a marketing strategy, but
also on being in compliance with federal guidelines for medicare
patients.  Unfortunately, the HMO turns a blind eye to the need for
timely follow up visits that may be required to provide adequate pain
relief.
Sometimes patients have to wait more than eight to 12 weeks to see me in
follow up visits, because there are not enough MD's in the clinic to
accomodate the demand.  I believe this is unacceptable, but have not
been able to force the HMO to provide more staffing.  My HMO has been
slow to respond to my advocacyfor the patients rights to timely
followup care.  Are there federally or state mandated standards that I
can use to make my case that we are
out of compliance?  The threat of loss of medicare reimbursement would
seem to provide the leverage needed to force the HMO to staff
appropriately so that patients do not have to wait 2-3 months for
their next visit.  Thank you.