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Fremont Dr. Ramineo Rao, who is featured in the documentary movie 'Life For Sale' is interviewed by media during a press conference in Newark, Calif. Thurs. Aug. 21, 2008. The movie alleges that hospitals discharge patients who are too sick to go home, and that they retaliate against doctors who don't play by the hospital's rules. In background the film's director Kimerli Zou, and Dr. Mark Schiller, former Association of American Physicians and Surgeons (AAPS) president. (Bea Ahbeck/The Argus)

FREMONT — Washington Hospital is singled out in a new documentary film that alleges hospital administrators have taken control of patient care from doctors and base key decisions on profits rather than patient welfare.

"Life for Sale," a feature-length documentary that will be shown at Cinedome 8 Fremont this week, contends that many hospitals discharge patients still in need of care and, as part of their profit-motivated policies, retaliate against doctors who challenge early discharges.

Although the filmmakers say the problem is widespread, most of the specific allegations are directed at Washington Hospital.

Cardiologist Evelyn Li, the film's medical consultant, says that Washington administrators retaliated against her in November 2005 after she canceled the discharge of a person she said was too sick to go home.

Earlier this month, she became an official candidate for a seat on the Washington Hospital board of directors.

Washington Hospital spokesman Chris Brown said he couldn't comment on a film he hadn't seen and didn't know was in production.

The film, which was screened for reporters Thursday, presents a grim picture of patient care.

Hospitals, it argues, have an incentive to prematurely discharge elderly patients because the Medicare reimbursements that hospitals receive are based on flat fees and don't take into account the number of days a patient is hospitalized.


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If patients stay for a long time, the hospital loses money, but if they are readmitted, the hospital can re-bill Medicare, Dr. Ajit Sandhu, former chief of staff at Washington, said in the film.

He said hospital administrators hire nurses to review cases and push them to approve early discharges. "They even tell medical staff leaders to do things that are inappropriate," he said.

Doctors who abide by hospital policies are rewarded financially, Sandhu said in the film. Those who challenge them face potential retaliation or a peer review committee chosen by hospital administrators, according to the film.

Hospitals use peer review to keep doctors in line, Dr. Ramineo Rao said in the film. Rao, a vascular and general surgeon who headed Washington Hospital's intensive care unit, said in the film that he was a victim of a "sham" peer review, but he refused to comment about it in a post-screening press conference Thursday.

Federal laws make it practically impossible for doctors to fight the findings of such review committees, according to the film.

Li said Washington administrators tried to force her from the hospital in 2005 after she canceled a patient's discharge. The hospital denied her the use of certain equipment and filed a negative report in a national data bank that made it harder for her to get certified in other states, Li said.

The 2005 incident wasn't her first battle with Washington administrators, Li said during the press conference.

One year earlier, she said, the hospital pressured a doctor to release patient Raymundo Abulgos without a prescription for medication even though he was suffering from pneumonia. Abulgos was quickly readmitted, but he died shortly thereafter, his daughter Lyn Abulgos-Cuevas said at the press conference.

"To discharge him early without antibiotics, that was kind of questionable," she said.

The film, which Li helped to fund, gives only her side of the story. No Washington officials or other industry professionals were interviewed, although Li said the filmmakers asked for their participation.

The film made frequent reference the salary Washington Hospital CEO Nancy Farber received last year, and devoted several minutes to extolling Li's virtues as a doctor.

Li, who now practices at the Asian Medical Clinic of Fremont, says she wasn't targeting Washington.

"This is a national issue, but we're here and the patients who are being affected locally are here," she said. "It's a lot easier than flying down to Texas and shooting patients there."

The film, which took three years and more than $1 million to make, was produced by the Fremont-based Orb Film Productions. Orb President Alexander Cheung said Li told him of her experiences and he connected her with filmmaker Kimberli Zou, who directed the film.

The movie is scheduled to run through Thursday at Cinedome 8 Fremont, 39153 Farwell Drive.

Fremont reporter Matthew Artz can be reached at 510-353-7002 or martz@bayareanewsgroup.com. Read his blog posts at www.ibabuzz.com/tricitybeat.