Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
The Bay Area Reporter - Thursday, May 20, 1999
Cynthia Laird
The seven gay doctors with large HIV/AIDS practices from California Pacific Medical Center (CPMC), formerly Davies Medical Center, said they were denied admission to Brown & Toland Medical Group and approached Supervisor Mark Leno about the problem. Seven other doctors from CPMC were admitted to Brown & Toland, prompting Leno to call last week's hearing. He made it clear he didn't buy Brown & Toland's position that the giant physicians' group doesn't know what doctors specialize in when they apply.
The gay doctors feel discriminated against because they were denied admission to Brown & Toland, and feel the medical group discriminated against them because they have lots of patients living with HIV/AIDS.
Leno pointed out several times that Brown & Toland's own application form asks what specialties, if any, a prospective member has, so that Brown & Toland officials would know if a doctor specializes in HIV/AIDS care.
"Brown & Toland does not discriminate, nor do we inquire physicians' patient profiles. I sit on the board of directors and I can tell you those aren't considered," said Dr. Tom McAfee, who said the group's decisions are largely driven by the Federal Trade Commission (FTC). The FTC has investigated the medical group and restricted the number of primary care physicians that can become members. McAfee said the impending closure of the Davies Medical Group could make a difference with respect to antitrust problems.
McAfee said Brown & Toland needs to go back to the FTC in light of the new information about the Davies Medical Group.
Brown & Toland, in a written statement distributed at the hearing, denied it engages in "AIDS redlining," and denied discrimination charges. More than 2,300 physicians belong to Brown & Toland, providing services to approximately 250,000 patients at the campuses of CMPC, University of California, San Francisco (UCSF) Medical Center, UCSF-Mount Zion Medical Center, Stanford Hospital and Clinic, and the Lucile Salter Packard Children's Hospital. Over 120 of Brown & Toland's physicians actively treat more than 2,100 current medical group patients with HIV/AIDS.
Dr. William Owen, Jr. one of the doctors denied admission to Brown & Toland, informed the supervisors that the Davies Medical Group is closing at the end of this month. He told the supervisors that Brown & Toland has virtually all of the contracts for major health maintenance organizations (HMOs). The other doctors who were denied admission are David Drennan, Toby Dyner, William Kapla, Myles Lippe, Lee Liskey, and Lawrence Price.
Owen said he and his colleagues were reluctant to come forward. "We are aware we might be embarrassed today," Owen said.
Owen requested that local officials urge the FTC to remove restrictions on Brown & Toland.
McAfee said the economics of AIDS care have changed over the years, so that Brown & Toland doesn't have any motivation to redline. Pharmacy costs have increased with the new medical treatments, he explained, but that those costs are borne by HMOs, not medical groups.
Several patients of the gay doctors spoke at the hearing and praised the physicians.
Leno said he'll continue to work to resolve the problem.
The Brown & Toland statement said there is no documentation of current applications for three of the seven doctors who have not been added to the group, two doctors are currently under consideration, and one was previously offered admission on two separate occasions but turned it down. No information was provided on the seventh physician.
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