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Ed Yeates ReportingCan a physician question the policy of an insurance company when, as he believes, it affects the welfare of his patients? That's the issue that could now go to a jury trial, after the company terminated a doctor's service to its clients.
Patients with varicose veins have a new procedure to treat their condition. Surgeons simply insert a radio frequency catheter in the affected vein and dry it up. The body absorbs the remains. The patient recovers rapidly.
Craig Wilkinson, M.D., Vascular Surgeon: "The new procedure requires no bed rest, is done as an outpatient and patients are back to work in one to two days."
That's what about 20 patients were preparing to do when Altius Insurance notified Dr. Craig Wilkinson the policy had changed.
Janet Jenson, Salt Lake Attorney: "The medical policy changed radically to require not one but two or more blood clots, two or more active bleeding sessions, or risking permanent disfigurement before they could be treated."
The change not only affected the new procedure, but the old one where affected veins are literally stripped or ripped from the leg. Dr. Wilkinson questioned Altius about the change, noting the risk of waiting.
Dr. Wilkinson: "Bleeding can be fatal; now, it's rarely fatal, but it can be. Blood clots, as you know, can travel to the lungs and cause pulmonary embolisms, which can be fatal."
Though the Salt Lake surgeon had been enrolled with Altius for six years, the company terminated his services after he questioned their decision. Altius terminated Dr. Wilkinson only six days before a law went into effect that would have prevented that termination.
Attorney Janet Jenson today petitioned the courts to issue a restraining order, but it was denied. So now they face a possible jury trial, and what Jenson says could be a much bigger issue.
Janet Jenson: "If our policy is going to be that doctors can be silenced for using their expertise to defend or protect their patients, then we're going to have a race to the bottom, and no one can be sure of getting good medical care."
Eyewitness New contacted Altius for its response, but had received no returned calls by news time.
The long-term cost of the less invasive outpatient procedure averages about the same as the old stripping technique.
