Seen a Rogue on the loose? Get in touch with our Roguemeister: JOHN SCHRAG jschrag@wweek.com (503) 243-2122 FAX: (503) 243-1115 When you take on a powerful health-care industry, it's nice to have researchers at one of the world's top teaching hospitals on your side. More than a year ago, Arlene Mullin quit her job as a medical technician when the Vancouver dialysis center where she worked changed ownership. Like many of the patients she tended to, Mullin felt that cost-cutting measures taken by the for-profit dialysis industry were reducing the quality of care. Mullin carefully detailed her complaints. She contacted Medicare administrators and sent a blizzard of information to Ralph Nader and officials in nearly every state. (See "Whistle-blower," WW, March 24, 1999.) Her package included letters from five fellow employees and two patients. Mullin's letters caught the attention of state and federal officials, who began to look at the trend toward privatization of dialysis clinics. The issue is particularly hot in Oregon, where 31 of the state's 39 dialysis centers are now run by for-profit companies. Executives at leading dialysis companies such as Renal Care Group disputed Mullin's charges. In fact, local representatives of RCG told WW this spring that care actually improves when for-profit companies take over clinics. Researchers at Johns Hopkins University recently weighed in on the debate. According to their study, published last week in The New England Journal of Medicine, dialysis patients at for-profit clinics are more likely to die and less likely to be referred for kidney transplants. That finding could help state officials get more federal funding for inspections of dialysis centers. The feds currently pay only enough to inspect each clinic once every 10 years. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Willamette Week | originally published December 1, 1999