A network without a net

Springfield Clinic physician tests the limits of Blue Cross and Blue Shield provider list

Yesterday, I was provided the opportunity to testify before the Illinois House of Representatives State Government Administration Committee on the impact of Blue Cross and Blue Shield of Illinois' termination of Springfield Clinic as an in-network provider for thousands of individuals and families throughout central Illinois. These are some of the patient stories I was able to share.

As an obstetrician-gynecologist who has been in practice for 19 years at the Springfield Clinic, I have a very special relationship with my patients. I am with my patients through the most joyous times in their lives when I deliver their babies. But I am also there during the most devastating times, when they come in for a perfectly routine obstetrical visit and there isn't a heartbeat, or I have to tell my patients they have breast cancer.

I have been caring for women throughout the region for generations – I take care of my patients' mothers and grandmothers. I have delivered all of their children and their nieces and nephews. Yet, today, the relationship with my patients has been severed because Blue Cross and Blue Shield terminated our relationship as an in-network provider.

My patients deserve better.

One of my patients was hemorrhaging, and needed a hysterectomy. It would have been unreasonable for her to wait months to get an appointment with an in-network doctor, so I attempted to help her find a physician. I went to Blue Cross and Blue Shield of Illinois' provider directory and, to my dismay, I saw a name that I was very familiar with; it was the name of the person who trained me in residency. He retired from obstetrics and gynecology 21 years ago, yet he was still listed as a provider taking new patients.

I went further down the list and saw names of physicians who do not provide obstetrical care. Many of them provide limited gynecological services, like STD testing and contraception, but they cannot care for my hemorrhaging patient. I continued through the provider directory and saw a group of names that I was unfamiliar with. I looked at the address and realized the address was not a physician's office. These doctors don't exist.

Can you imagine the frustration a patient must feel when their health plan, Blue Cross and Blue Shield of Illinois, tells them that there are thousands of providers available, but when they call an office, they're told that it will be several months before they can be seen? Or they call an office that does not provide the services that they need? Even worse, they call an office that doesn't even exist?

Can you imagine that for yourself? For your wife? Your mother? For your daughter?

My patients and the women in central Illinois need and deserve so much more.

Dr. Cheryl Brown, M.D., of Springfield, is an obstetrician-gynecologist in practice with Springfield Clinic.

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