An employee assisting Jackie and me in a patio store told us her horror story about how her HMO’s emergency care doesn’t work, when patients need it. An HMO doctor removed a tumor from her back. However, the HMO doctor failed to instruct her about emergency care, should problems occur. We wondered why the doctor didn’t do her duty. I found out.

Her HMO’s "Medical Legal Department" instructs all physician-shareholders in the HMO’s for-profit Medical Group as follows: "Remember: Your duty as a physician is to recommend—not to approve—treatment…Refrain from blaming someone else (especially the health plan) for the patient’s condition or outcome."

What happened to this unfortunate woman?

• The wound opened. She needed emergency care. It was a weekend.

• She could not contact her surgeon. The HMO medical office was closed.

• No HMO urgent care facility would see her, much less treat her.

• She telephoned the HMO hospital’s emergency room (ER) for help, as the HMO’s "HANDBOOK" instructs patients to do. She was told that no one in the emergency room was qualified to treat her. She was instructed to telephone her surgeon who had not provided a telephone number.

• When she finally saw her surgeon the next week at a location 30 miles from her home at 8:30 at night, the doctor angrily told her that she should have come in for care when the wound first opened.

HMO emergency room doctors identify patients as "GOMERS," i.e., Get Out of My Emergency Room. They refuse to admit that HMO "members" are "patients" who, as Jesse Ventura might say, "ain’t got time to bleed."

Don’t get caught in HMO "CATCH-22" logic that victimized this patient. She tried to contact her surgeon but couldn’t. Her surgeon then blamed her for not taking "responsibility" as the HMO and HMO doctors require. "GOMERS" must learn how to play HARDBALL to get care.

• Keep copies at home for yourself. Be sure to tell your family about the forms. Put a copy in all your vehicles.