Closed network systems like Kaiser and open networks systems like Aetna, Pacificare, etc are all limited by the primary care doctor you choose.
Kaiser lets you change your primary doctor. If you think your doctor is misdiagnosing you or a family member or not pursuing an appropriate course, change doctors, go to urgent care (if appropriate) etc. Most people are sheep when it comes to medical care… and doctor’s are human.
You have to advocate for your care with ANY doctor or insurance. For example, I have a paranoia about my cancer risks. (I’ve mentioned previously – 3 of 4 grandparents had cancer, dad had 2 separate malignancies, mom had ovarian, my brother had 2 separate malignancies, I have 3 cousins and 2 have had cancer). But I have a small family so I don’t meet the statistical requirements to fall into high risk. (Not enough aunts/cousins to sample from.) But – I talked Kaiser into increasing my mammograms, doing annual u/s’s to look for ovarian cancer, and doing ca125 tests to see if it ever goes up. These are all fairly low cost, but not typical. I had to ask for them, but when I laid out my case, it was agreed to immediately.
ocr’s point about people blaming a private practice doctor vs a system is accurate. I’ve heard similar complaints about the VA system. My father in law gets his care at the VA and I have to say – it’s a LOT better than the care he was getting through a doctor under blue cross/blue shield. But he’s got people advocating for him here. My husband and I go with them to his appointments, ask questions, do research.
