11.   And my regular doc, who has been in practice for a few decades, has seen patients go through all types of hernia repair over the years.

12.   Are Medicaid patients going to its emergency room out of habit?

13.   As a physician, you tend to minimize what your patients are going through.

14.   As far as the patient went, they were baffled.

15.   At the end of six weeks, the patient was going blind and was finally referred to an ophthalmologist outside the HMO.

16.   Best of all, the surgery requires no incisions and the patient can go home after only a few hours.

17.   - Is the patient going to die anyway?

18.   A patient goes to the doctor complaining of persistent depression or overwhelming anxiety or some other malady of the mind.

19.   But she pointed out that not all HMO patients went to free-standing centers, nor did all fee-for-service patients go to academic centers.

20.   But the system presumes that a patient goes to the same pharmacy every time.