In California, the SEIU has leaked an internal John Muir Physician Network (JMPN) memo that instructs doctors not to "refer patients for a screening colonoscopy if their life expectancy is less than five years." The memo orders doctors to deny the test to patients with AIDS, chronic renal failure, advanced cirrhosis of the liver, COPD, active hepatitis, obesity and other conditions. The memo also threatens "financial penalties" for doctors who don't comply with the order. Taken at face value, JMPN's blanket denial of colonoscopies for certain patients is a violation of several federal laws. JMPN officials are saying that the memo isn't a sign of any unethical behavior; rather, the network would like to see elderly and fragile patients undergo less invasive procedures in order to avoid possible complications. "We really believe in colorectal cancer screening. But we were concerned about some of the complications patients have had with colonoscopies," Mike Kern, network medical director, told the Contra Costa Times.

The SEIU leaked this memo as they are preparing to strike at John Muir Medical Center's Concord campus. The SEIU is incensed that its contract with JMPN requires all union members to receive treatment at JMPN-affiliated providers. The memo, they say, illustrates the point that JMPN may not be the best facility for their treatment and that they should be given a choice to receive care from another provider. Regulators say they are planning to investigate the matter.

For more on the controversy:
- check out this article [1] from the Contra Costa Times
- and read the SEIU press release [2] for more details from the memo