I see your point and I agree.

My understanding is if you are working with an HMO here in CA,and haven't had the outcome you expected, the patient can file a complaint with the Department of Managed Healthcare ( I don't know if this applies to all situations, or states).

My husband filed a complaint after being denied a procedure he wanted at our HMO. He was concerned because he had filed a complaint against the Surgeon who was to do his his cancer surgery as he wanted a different type of treatment. They ruled that the procedure the Surgeon had reccomended doing was fine and an acceptable treatment. Rather than allow the cancer to continue to grow, he went ahead and had the procedure done. His worst fears were realized and he had major radiation damage from the procedure.

My husband's second case is now being filed with the board, and in this one he is filing charges against his HMO for his radiation burns. We were told we had to go this route first before we could pursue legal charges. You go before a Independant Medical review board and present your evidence or have an authorized representative present it; it doesn't cost you anything to file or appear before the board.

Maybe others can tell you if they have taken that route and had a good outcome.

This is supposed to be a way to have the Surgeon disciplined, or his liscense revoked with out having to involve another Surgeon who may be unwilling to voluntarily participate.

I hope that maybe this time I have better understood your question and been able to help some,

G~