Dr. Doug Curran is everywhere these days. The longtime Athens-based family physician has been spotted in a few magazines you may have heard of, such as Newsweek and Sports Illustrated.
Through his longtime association with Blue Cross Blue Shield of Texas, Curran appears – wearing his white lab coat, clutching a stethoscope and looking more serious than one usually finds him – in a series of their print ads.
While those ads have garnered him the most attention over the last few months, a less visible appearance in another magazine carries even more prestige.On page S-18 of December's Texas Monthly (S for Super), Curran's name is listed under the Family/General Practice section of "Texas Super Doctors 2005."
Dr. Dee Whittlesey describes Curran as "a physician's physician.""He's a man who cares deeply for his patients and will go to any lengths to make sure they get the best care," said Whittlesey, who serves as VP in the Office of Physicians Advocacy for Blue Cross Blue Shield of Texas. Before that she worked 23 years in obstetrics and gynecology.
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Friday, May 9, 2008
Blue Cross Blue Shield Vs. Private Family Physicians...Corruption in Texas Part One
This is Dr. Doug Curran and the picture you are looking at is an advertisement he did for Blue Cross/Blue Shield. This testimonial and the story that surrounds has major implications on the way that health care is determined today. This is the first of a three part series that will examine Curran's role in a serious and systematic corruption by Blue Cross Blue Shield. In the first part, I will lay out some serious charges against Curran and some other colleagues as well as Blue Cross Blue Shield itself. In the second part, I will lay out the evidence to prove those charges. In the third part, I will give my conclusions for what all of this means in the larger health care debate.
Dr. Curran is a private family practioner in Athens, Texas at the East Texas Medical Center. By appearing in this advertisement, Curran appears to have violated the Texas Medical Practice Act's ban on so called testimonial advertising. Furthermore, he violates all sorts of ethics regarding conflicts of interest by appearing in an advertisement for his most significant insurance carrier. The whole affair becomes even more curious when only a few months later a puff piece with quotes from BCBS hierarchy as well as references to BCBS finds its way through the internet.
As you can see, besides appearing for an advertisement for BCBS, Dr. Dee Whittlesey of BCBS is quoted within this article. Furthermore, his connection to BCBS is mentioned multiple times throughout the article. It is one thing to have a good and professional relationship with your insurance provider, however it is quite another to simply get into bed with them. This article and the advertisement previous to it are two examples of a long and winding story in which Curran wasn't merely friendly and professional with BCBS, but in bed with them.
Besides being a small town doctor, Dr. Curran was also, for several years, the head of the Texas Academy of Family Physicians (TAFP). This is the Texas branch of the most powerful organization that represents the INTERESTS OF FAMILY PHYSICIANS. Furthermore, Dr. Curran is one of three members of super secret committee of the Blue Cross Blue Shield Texas Medical Advisory Board. This is a committee that the general public is likely not supposed to know exists. This committee reviews the performance of other family physicians that are contracted with Blue Cross Blue Shield and determines if any have stepped out of bounds. Furthermore, this committee is intimately involved in determining proper punishment for those physicians that Blue Cross Blue Shield determines to have stepped out of bounds. In other words, Dr. Curran is playing both sides of the proverbial fence. Not only is he representing the interests of family physicians, (Of course, many times those interests confront the interests of BCBS) but he then turns around and represents the interests of BCBS against family physicians.
Curran serves on this BCBS committee with two other physicians, Dr. Keith Miller, and Dr. Fred Merian. Dr. Keith Miller was also the long time head of the Texas Medical Board Disciplinary Committee and Merian was the head of the Texas Medical Association. Furthermore, Miller is a private family physician in a town called Center, Texas. This is a town of a few thousand, and Miller has spent his entire professional life serving in relatively small towns like Center, Texas.
Several issues should already come to mind. Why are three such powerful people also in a position of power at BCBS? How does a doctor centered in a relatively small town wind up finding himself in the middle of so much disciplinary and decision making power? The answer is that these three were put there by BCBS to corrupt the system to punish private family physicians in Texas that BCBS determined were too expensive.
The relationship between private family physicians and BCBS, and other insurance companies frankly, is a naturally confrontational one. Unlike doctors at big hospitals, private family physicians get paid by the medical version of commissions. Ulike doctors at large hospitals or hospitals associated with universities, private doctors only get paid when they have patients. Furthermore, there is a sliding scale that BCBS, and other insurance companies use, to determine how much they get paid. The more comprehensive leads to more fees. This is determined by patient evaluation forms that doctors fill out. Whereas doctors at hospitals rarely if ever fill these forms out, private doctors use this as the lifeblood of their business. Think of private family doctors as the ultimate capitalist in the medical field. They have to fight for every nickel they make, and they are the ones most motivated to fight for it.
The BCBS Texas Medical Advisory Committee reviews the billing of private doctors in Texas. Keep in mind that Dr. Miller, for one, is himself a private Texas doctor. This is of course an obscene conflict of interest. Unfortunately, the corruption doesn't end there. BCBS employs these three to procure a practice known as sham peer review. Sham peer review is the corrupted process of medical peer review . Instead of determining whether or not a doctor stepped outside of medical guidelines, sham peer review merely punishes doctors that powerful forces deem a threat. The process can be summed up the phrase: judge, jury and executionor. The corrupt force finds a way to bring up trumped charges, they have someone on the panel's jury, and they usually have someone presenting the evidence. Dr. Miller's position as head of the disciplinary board puts him in a unique position to corrupt a legitimate peer review and turn it into a sham peer review. In other words, these three don't merely work for BCBS to perform private physician evaluations, but rather, they are strategically placed by BCBS within all parts of the medical system to corrupt it to punish those doctors that BCBS determines to be a threat.
As such, these three doctors have gotten into bed with BCBS in order to help BCBS root out those of their colleagues that they determine too expensive to keep around.
In part 2, I will tell the story of Dr. Shirley Pigott. She is just one of those doctors that BCBS determined too expensive to keep around, and as such, she wound up crossing paths with all three as she was systematically retaliated against through sham peer review.