So the fact that your family doc/specialists are "in network" with UPMC now does not mean they will remain so.
I just spent the day attending meetings with a friend whose husband is a cardiac specialist with UPMC. She told me that UPMC administration was expecting a large number of people to leave Highmark & switch to UPMC, but that didn't happen. Therefore many layoffs of UPMC personnel are expected within the next few months.
I'm fortunate to have my supplemental insurance, Highmark Blue Shield, paid for as part of my retirement package, and I have no limitations on my choice of docs, including specialists. I really research to get the best specialists, and my family doc, orthopod & podiatrist are not part of UPMC. My endocronologist, audiologist & eye doc are UPMC, but if they get laid off, I can follow them to wherever they go.
My UPMC endo's assistant told me that the doctor has to schedule about 28 patient office visits per day, and being the top of her field, her patient load includes those with the most complex medical histories and conditions. At this point she is not even taking new patients and I was lucky to get in to see her (after 6 months on a wait list).
By contrast, my orthopedic surgeon was pushed out of UPMC because he "took to much time talking to his patients." An UPMC orthopod I saw previously told me on my first (and only) visit that I needed 2 full knee replacements immediately. (I had gone in to ask about cortisone shots.) He also told me I should get them both done simultaneously. Then, after he gave me the cortisone shots, he suddenly looked worried and said, "You're not a diabetic, are you?" He had full access to all my UPMC records, including those of my UPMC endo doc. Further, I had specifically told his nurse and then his resident that I was a diabetic. Turns out if I was on insulin, those cortisone shots could be problematic. Fortunately I'm on oral meds, not insulin injections. However, it confirmed my impression of a doc who wanted to operate as soon and as much as possible to make as much money as possible. So I found my new orthopod - that was 3 years ago. I don't need full knee replacements - I can get by with partial knee replacements and don't need those yet. Other reasons I know my new orthopod is ethical & skilled is that he's the doctor other docs send their family members to, AND he spends a month each year operating at a mission hospital in Niger. Further, my new, non-UPMC orthopod took more detailed xrays, and carefully angled the cortisone shots deep into my knee joints. The first doc took fewer xrays and just jabbed the cortisone injections into the top of my knees. Bottom line, it's been 3 years and I'm doing well with no surgery, twice yearly cortisone shots, a little weight loss and some exercises my new orthopod recommended.
What gets me about UPMC is that it makes huge profits - I suspect the conflict with Highmark is just the excuse Jeffrey Romoff needs to reduce medical personnel, place even tighter time constraints on the remaining docs and nurses, and further increase his salary & annual bonus.
UPMC paid 26 employees over $1 million last year
May 17, 2013 12:00 AM
By Steve Twedt Pittsburgh Post-Gazette
Of UPMC's 55,000 employees, 26 received at least $1 million in total compensation last year, led by president and CEO Jeffrey Romoff at $6.07 million, followed by executive vice president Elizabeth Concordia, who received $2.5 million in salary, bonuses, retirement and other compensation, and neurosurgeon Ghassan Bejjani, whose compensation was $2.48 million.
(Romoff actually makes even more because he plays a game with "deferred compensation.)
It's tough to make the right choice on health insurance - as to the supplemental policy, just keep in mind that Medicare gives you a window every year in which to change your provider.
On Edit: What I don't like about UPMC - they overload their docs with demands to see too many patients each day (and that can result in medical errors), and pressure their docs to recommend unnecessary surgical procedures. That new hospital in Monroeville, UPMC East? Flat screen tvs in every room, mostly private rooms, very luxurious, offering in room hair dryers, pizza baked in a pizza oven, smoothies, etc. It's been compared to a hotel. That's just great, but I'd rather that money was spent on hiring enough medical personnel so that doctors could take a little more time with each patient.
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