Local doctor forms medical grievance committee
Now patients and their families have a place to go when they have a grievance against a local doctor, hospital or any health insurance company.
Dr. Ira Jaffrey, a Glenwood Springs oncologist and president of the Mount Sopris Medical Society, has formed a grievance committee to handle complaints.
“It gives people an opportunity and a method to voice their problems,” he said.
As a past member of the Rockland County Medical Society in New York, Jaffrey said most complaints fall into two categories.
“The first is the failure of the physician to communicate with the patient,” Jaffrey said.
He’s heard people say, “I called the doctor and it took him two hours to get back to me.
“Some people think that’s unconscionable. Maybe he was on top of McClure Pass in a snowstorm. But if the ER said they tried to reach a doctor six times in four hours and he was on call,” then that needs to be looked at, he said.
The second most common complaint is about money, Jaffrey said. People commonly get a letter from their insurance carrier saying it will pay only part of a doctor’s fees because “the doctor’s charges exceed the usual and customary charges for that area,” he said.
As a result, “the patient thinks the doctor is overcharging,” Jaffrey said.
Insurance companies determine what to pay for doctors’ services in certain areas by looking at a zip code and coming up with an average number.
“It’s ridiculous. It’s like saying the Little Nell (in Aspen) overcharges because you can get a cheaper meal at McDonalds,” Jaffrey said.
“Sometimes it’s just a matter of explaining it, and sometimes they’re entitled to better compensation,” he added.
Patients who have a complaint can write a letter to the medical society, which will be reviewed by the grievance committee. If the complaint is simple, the committee will write a letter of explanation, Jaffrey said.
The four-member committee sees the letter without knowing who the writer is, to give an unbiased opinion, he said.
If the issue is about a physician, the committee may ask him or her for explanation. If the explanation is not satisfactory and the issue is serious, it could be referred to the state medical society.
The local medical society has legal jurisdiction over any member, Jaffrey said, and that includes most doctors in the area.
State medical societies provide continuing education for doctors, Jaffrey said, and monitor physicians under surveillance for alcoholism or drug abuse, as well as handling complaints handed on by local medical societies.
Although Jaffrey said he felt there was a need for a grievance committee in the valley, in reality, he said, “I haven’t heard of a groundswell of complaints.”
Until now, patients with a complaint have either written to their doctor or to the hospital, he said.
“Aspen Valley Hospital has an ombudsman for patients,” he said. “Both hospitals in the valley are always reviewing patient satisfaction surveys. They’re really very receptive to patient needs and go the extra mile to take care of them.”
Doctors also often act as ombudsman for their patients.
“Sometimes my patients will say, `They’re breaking my chops in X-ray,’ and I’ll call them up,” he said.
Although he expects to hear some unjustified complaints, Jaffrey also acknowledged that people may also raise justified grievances.
“In reality there are people out there who have something to get off their chest and we can provide the means to help them,” he said.
Anyone with a complaint for the grievance committee should call 970-213-2808, which reaches the secretary of the state medical society in Grand Junction. She will forward the complaint to the grievance committee.
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