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Contact: Sherry Milligan

Health Care Ethicist to Speak at Respiratory Congress

July 12, 2002 (Dallas, Tex) -- The American Association for Respiratory Care will welcome health care ethics crusader Linda Peeno, MD, as a keynote speaker at it's 48th annual International Respiratory Congress this October 5-8 in Tampa Bay, FL.

Known throughout the country as a tireless supporter of patients' rights, Dr. Peeno will address the assembly on the serious flaws inherent in the managed care system.

"The major deficiency is that the business of health care has exploited the concept of 'management' of health care for its own economic gain," says Dr. Peeno. "Consequently, a model of 'managed care' has evolved that depends upon limitation and denial of care in order to succeed, because 'success' is defined economically, not clinically."

The subject of a recent Showtime movie starring Laura Dern, Dr. Peeno has been compared to environmental activist Erin Brockovich and tobacco industry whistle-blower Jeffrey Wigand for the courage she has shown in speaking out about the need for better access to health care services for all Americans. The Showtime movie, Damaged Care, debuted at the end of May to positive reviews.

Linda Peeno's mission to change the health care system began in the mid-1980s when she took a job as a medical reviewer at Humana, examining patient records to ensure the tests and procedures ordered by doctors were really necessary. Knowing that some physicians were prescribing unneeded medical care for their patients, she initially viewed the position as a way to minimize waste in an economically fragile medical system.

"When I started at Humana, I had had two significant experiences . . . One came from my medical training, where I witnessed many unnecessary procedures and types of care given to patients," she says. "The second experience came from my work at a local hospital doing utilization review for Medicare patients . . . I had even more direct experience with some physicians who admitted patients and kept them in the hospital inappropriately."

The hospital worked hard to balance care against costs, and she thought the same would be true at Humana. It wasn't long, however, before the denial practices at the for-profit MCO led her to believe the company was swinging the pendulum too far in the opposite direction, denying necessary services to patients simply to appease stockholders interested only in the bottom line. The defining incident came in 1987, when she was forced to deny a heart transplant for a patient who subsequently died.

During testimony before Congress in 1996, Dr. Peeno related the experience. "In the spring of 1987, as a physician, I denied a man a necessary operation that would have saved his life, and thus caused his death. No person and no group has held me accountable for this because, in fact, what I did was, I saved the company a half a million dollars . . ."

The incident spurred Dr. Peeno to leave Humana, and she went to work as a medical reviewer for a smaller, non-profit HMO instead, hoping such abuses would not occur at a company that wasn't in the business of making huge profits. But similar problems eventually developed there as well. At that point, she quit her job and spent two years studying health care law, ethics, and philosophy.

"I realized that there were fundamental problems in the model of managed care that existed and was evolving . . . my love for medicine and my strong sense of the importance of patient-centered care led me to quit and find other ways to change what I had begun to experience."

Part of her mission is to better ensure patients receive necessary care from medical professionals actually trained and qualified to deliver those services - not low cost, unlicensed, on-the-job trained personnel instead. For example, she believes patients deserve to receive respiratory care services from respiratory therapists - the only allied health practitioners with extensive training in the respiratory system.

"I recall my earliest experiences as an intern trying to manage complex critically ill patients and how much I relied upon respiratory therapists to assist me with assessment, treatment, and management of patients."

Dr. Peeno again testified before Congress in 1997, educating lawmakers on what she termed, "the menace of managed care" She has also served as an expert witness in numerous trials involving patients who were denied medical care by their HMOs or managed care companies. In the late '90s, her testimony was considered essential to winning what was then the largest liability judgment ever in Florida in a case involving a small child with a debilitating congenital illness who was denied treatment by the family insurer.

Linda Peeno received her undergraduate degree from Morehead State University in Morehead, KY, and her degree in internal medicine from Murray State University in Murray, KY. She currently resides in Louisville, KY, where she serves on an ethics committee at the University of Louisville Hospital.


The American Association for Respiratory Care, a professional membership association of respiratory therapists, focuses primarily on respiratory therapy education and research. Its goals are to ensure that respiratory patients receive safe and effective care from qualified professionals and to benefit respiratory health care providers. The Association also advocates, on behalf of pulmonary patients, for appropriate access to respiratory services provided by qualified professionals.