How did your HMO initially view active surveillance?

How did your HMO initially view active surveillance?

Patient Francisco Jiminez Transcript

Opening Title: How did your HMO initially view active surveillance?

In 2006 when I was diagnosed, my HMO doctors suggested a prompt surgery or radiation… When I joined the HMO support group, I felt that the presentations were quite average. They seemed to be skewed towards what the HMO had to offer. And I questioned the fact that maybe there were other ways to treat my PC, but they wouldn’t have it any other way, and therefore I started questioning even more why we were not given more information and because of my medical record and because of the what I call voracious appetite for knowledge as far as my condition was concerned, I went against the tide and I chose watchful waiting at the time and they said that I was out of my mind…they told me that only patients 75 or older should consider watchful waiting as an option. At that time I was 61.

They mainly ignored my questions or at times I had to hold my hand up for over twenty minutes until they would acknowledge me. Or even wait until the end of the meeting to say go ahead, ask your question. They also were belittling our questions.

They called our research suggestions a fad…Eventually, I was called aside and told to be quiet.I had to be quiet at the meeting.

But the rest of the group was surprised, some were staying past the regular meeting to be able to talk to me in our smaller active surveillance meeting and they started asking those uncomfortable questions in later sessions. Our attendance increased and more patients participated.

We would discuss our findings immediately after the general meeting had ended. Months later, the HMO banned us from their conference rooms. We used their waiting rooms and their cafeterias to have our meeting and eventually we chose a restaurant chain….

The HMO staff gradually changed their attitude… As I said before we were relentless, we brought in medical journals, medical articles in very well-known from institutions both locally and worldwide. That would backup our beliefs about active surveillance.

Many of the proposals and procedures that we suggested are now mainstream in our HMO. Particularly the active surveillance option for low grade prostate cancer patients. We now feel there our work will have finally paid off….Our model is act from knowledge, not from fear.

Closing Title: Ghandi

Patient Francisco Jimenez recounts his travails in overcoming HMO resistance to active surveillance back in 2006.
Patient Francisco Jimenez

Patient Francisco Jimenez recounts the resistance to active surveillance that he experienced at his HMO. 

At age 61 Francisco was diagnosed with prostate cancer. Experts each recommended a different treatment. Francisco, an engineer, carefully educated himself about his options, choosing active surveillance. At his HMO, Francisco attended regular support group meetings but found the HMO highly resistant to active surveillance, labeling it a “fad” and not a viable alternative. Francisco formed a small active surveillance support group with other members of the larger HMO support group. The group grew and finally the HMO’s policy incorporated active surveillance as a standard option for patients with low-grade disease. Francisco’s persistence won out.
Video reviewed and approved by Francisco Jimenez, August 1, 2015