could have already had some undesirable fallout.
“Yesterday. Just in case there was some clause or other like the one they have requiring preapproval for everything, I called them shortly after we got home from here to inform them about the change we wanted from Dr. Hollister to you. The woman who answered the phone checked around and then called me back to say they have a contract with Excelsius Health that includes the requirement that the referral surgeon is the only one allowed to operate on Steadfast Health patients.”
Will was stunned. Was this yet another managed-care game?
“What do you mean contract?” he asked. “What’s Excelsius Health got to do with this?”
“From what I was told when my primary-care doctor scheduled my mammogram, Steadfast Health is too small to have cancer centers the way Excelsius Health does, so their patients are X-rayed at the Excelsius mammography clinics, and if they need it, they’re treated at the Excelsius cancer centers. Then, I guess, Steadfast Health reimburses them somehow.”
“Well, this is just crazy,” Will said. “I’m on the provider panels for both Steadfast Health and Excelsius.” Even though, he chose not to add, Excelsius had tried several times in the past to have him removed from their provider list for various technicalities, including failure to get a form in on time.
“No matter what,” Grace said, “my husband and I have decided that we want you to do my biopsy, even if we have to pay for it ourselves. We have some money saved and-”
“Stop right there. This is absolute nonsense. You aren’t going to have to pay for this yourselves.”
The oversize manila folder with Grace’s mammograms in it was still propped against his desk from the previous evening. It was ironic and somewhat amusing that he had completely missed the Excelsius Health label in the upper left corner. Briefly, he scanned the films once more. The cancer was as he remembered-not huge but, in truth, indisputable. Biopsying the lesion would be technically simple, as would be its removal, provided there were no local lymph nodes with cancer in them. If the cancer had spread to the nodes-a part of the system draining foreign matter from the body-a meeting with the oncologist would be worth having to decide whether removing the lump or the upper outer quadrant of the breast would be statistically the best way to go.
Charles Newcomber was the radiologist who had read the mammogram, dictated his reading, and subsequently referred his patient to Susan. Emphasizing his title to the Excelsius Cancer Center operator, Will had no problem getting patched through to the man, who had a rather high-pitched voice and a fairly pronounced British accent.
“Dr. Newcomber,” Will said after introducing himself, “I’m here with a Mrs. Grace Davis, who had a set of mammograms that you correctly read as showing probable cancer.”
“Well, I’m certainly relieved at being deemed correct about such a thing.”
“Oops. I’m sorry, Doctor. I hope you know that’s not what I meant. I really do apologize.” Will expected the man to say something that would help ease his discomfiture, but there was only silence from the radiologist. “I. . um. . the problem I’m calling about is that you referred Mrs. Davis to Dr. Susan Hollister, who is one of my partners.”
“Yes?”
“Well, it turns out that Mrs. Davis and I have a history together that goes back more than ten years.”
“How sweet,” Newcomber said.
Will sensed his neck redden, but held his tongue in check. Newcomber was part of the Excelsius Health family. It was quite possible he was aware of the forum and its aftermath. Perhaps he had even been there.
“Dr. Newcomber, Mrs. Davis is here with me right now. She would like me to perform her surgery. I have spoken with Dr. Hollister, and she has no problem with the change.”
“I’m afraid that isn’t possible.”
“What?”
“Dr. Grand, first of all, this cancer center has an approved list of consultants from which we select a surgeon based on our patients’ hometown and any sexual preference. Dr. Hollister is on that list. You, sir, are not. Secondly, I have made it a point to personally get to know any surgeon to whom I make a referral. I don’t know you at all. If Mrs. Davis has a problem with that, I suggest she make an appointment to come in and share her concerns with me.”
Will could barely speak.
“Dr. Newcomber,” he managed, “who is your supervisor?”
“
“Well, you’re not the boss!” Will shot. “And my name’s Grant, not Grand.”
He slammed the receiver down.
A call to information gave him the number of the headquarters of Excelsius Health. He and Boyd Halliday had mixed it up yesterday, and Will was more than ready for another go.
“There’s no way they’re going to get away with this,” he muttered as much to himself as to Grace.
“Excelsius Health, the leader in cost-effective, comprehensive health care. How may I direct your call?”
“This is Dr. Grant. Mr. Halliday’s office, please.”
“One moment.”
“Boyd Halliday’s office. May I help you?”
“This is Dr. Will Grant. May I speak with Mr. Halliday, please?”
“Dr. Willard Grant? From last evening?”
“That’s right.”
“Um. . just a moment, please.”
For nearly two minutes, Will sat with the phone pressed to his ear, listening to a Spanish flamenco guitar piece and looking across at Grace. Her transformation, while certainly remarkable, was not the only one of its kind he had encountered. Over his years as a physician and as a volunteer at the Open Hearth, he had known a number of alcoholics and drug addicts who had failed at rehab again and again, only to suddenly get it and become straight and sober forces for good in their own lives and the lives of many others. His own dentist had survived a horrible stretch of drinking, during which he was hospitalized more than two dozen times in a ten-year period. Now, twenty years into recovery, the man was something of a saint, practicing his craft with wonderful skill, while helping countless men and women in and out of his profession to face their demons and prevail.
“Dr. Grant?”
“Yes.”
“Marshall Gold here. Mr. Halliday is at an all-day conference. Is there anything I can do to help you?”
The time spent on hold had done nothing to help Will calm down. Barely pausing to breathe, he recounted the situation with Grace Davis and his disturbing conversation with Charles Newcomber.
“I am on the provider panel for both Steadfast Health and Excelsius,” he railed, “and so there is absolutely no reason to prevent me from caring for this woman-”
“Dr. Grant-”
“I promise you, if Boyd Halliday doesn’t intercede in this case and set matters straight, he’d better be watching the news and reading the papers, because I won’t hesitate to bring Grace Davis to them and-”
“Dr. Grant,” Gold repeated calmly.
“What?”
“We’re sorry for the confusion. We have no problem honoring Mrs. Davis’s request to switch to you for her surgeon.”
“You don’t?”
“No, sir.”
“But Newcomber-”
“The arrangement we have with Steadfast Health has, from time to time, generated some confusion. I’m sorry that you, of all physicians, on the day after the Faneuil Hall forum, of all days, have been caught up in it. Hopefully, in the very near future, Steadfast Health and Excelsius will be merging, and such misunderstandings will be eliminated altogether.”
The freight train of Will’s anger screeched to an immediate halt.
“You can speak for Halliday on this matter?”
“As I said, you are not the first physician to be caught up in this sort of situation. So long as you are a provider on our panel, which I most certainly know you are, you have been screened in depth by our credentialing
