Albert Tzeel, MD, MHSA, CPE, FACPE, is national medical director for HumanaOne and is based in Mequon, WI.
There is an old joke that states that there are two
kinds of people in the world: those who believe that there
are two kinds of people and those who don’t.
The natural tendency of humans, as a species, is to
reduce larger sets into smaller subsets and to categorize
or classify sets as different. Such divisions allow a per-
son to make better sense of the world along the lines of
the phrase, attributed rightly or wrongly to Phillip II of
Macedon, Julius Caesar, or Sun Tzu, “divide and conquer.”
Of course, dividing any group into two groups usually
leads to specific dichotomies: good versus evil, right versus
wrong, smart versus dumb, and practicing clinician versus
health plan medical director. So it was when I found myself
relegated to the second part of the dichotomy.
Several years ago, my family and I were invited for a
social event at the home of my Rabbi. This dinner event
was a first for us at this temple and we looked forward to it.
Upon arrival, we were warmly greeted and entered to meet
the rest of the assembled guests.
By pure chance, one of the other guests also happened
to be a physician so, naturally, our Rabbi introduced us to
one another as we surely must have a lot in common. And,
as physicians are wont to do, we began by stating our specialty and our current practice mode.
Dr. X. began, “I’m a PM & R doc and I’ve been in solo
practice for the last 10 years since I left the faculty practice
at the university.”
“I’m a pediatrician by specialty but I have been in
administrative medicine for the last 12 years,” I replied.
“Oh, really?” said Dr. X. “Where?”
“I work for one of the health plans in town and have
been doing so since moving here nine years ago.”
Dr. X stiffened up. “You work for a health plan? You
Here it comes, even though this is not the forum, not
the place and certainly, of all instances, not the time for
him to launch a loud, abrasive, verbal assault on behalf of
all “good” practicing clinicians, like himself, against me
and my “evil” health plan medical director colleagues.
“You people did [fill in the blank], you people also
did [fill in this blank, too] and even if you people didn’t
do [find something else to fill in the blank with], I don’t
remember so it doesn’t count in your favor!”
Axe to grind
Dr. X clearly had an axe to grind and in order to return
a measure of civility to the Sabbath meal, I offered him my
business card (with my direct phone number), asked him to
call me on Monday and promised him that I would straighten out whatever concerns he had to the extent that I could.
And if I couldn’t change the outcome, I would, at least,
explain why so that we could, hopefully, reach a mutually
Even though my offer was accepted, albeit begrudgingly, I had already come to the realization that my appetite
was gone, my spiritual calm had dissipated and my weekend was off to a hellacious beginning.
Why? Because I wasn’t treated as the physician col-
league I was but, rather, had been relegated to a secondary
class – the class defined as “you people…”
I addressed Dr. X’s concerns on Monday, although
still not to his complete and utter satisfaction. Despite my
doing so, this kept me as one of “you people.” Yet, although
this happened years ago, it still bothers me to this day.
While I am better served moving on and letting go, I
can’t. As I think about that time, even while writing this
column, I think what bothers me most is not the fact that
there are still some physicians who, for whatever reason,
believe that anyone and anything associated with any entity that dares to question the great and mighty Oz (and I’m
not referring to Dr. Oz of television syndication but, rather,
to how physicians operate behind the “curtain” of practice)