Grievance for Highmark re “The Dr. Goldstein Special”

Text of my 2022-06-25 grievance for insurer Highmark Health Options (part of Blue Cross/Blue Shield), re “The Dr. Goldstein Special.” This is a follow-up to the gaslighting, cherry-picked facts, and twisted reality in prior Highmark responses.

Explain the Details of Your Grievance: 

Apparently, Highmark Health Options’ grievance team can’t understand the concept of non-consent. Or, they are paid to dance around the truth and avoid actually doing anything to support patient safety and agency. So, I’m laying it out super clear and super simple here. 

In sum: 

This was non-consensual surgery. 

Non-consensual surgery is highly unethical. 

This perpetrator caused great harm to me. 

The surgeon has done this to unknown numbers of other victims.

I remain a high utilizer because I’m trying to recover from Goldstein’s heinous act. 

Although he promised no tissue would be removed and there would be no external incisions, on 2019-01-03 Howard B. Goldstein DO cut approx 2 square inches of healthy tissue from my genitals without consent. This was for a condition about which I had no complaint, did not consult with him about, for which he did not explain the procedure, benefits and risks, or recovery, nor did he obtain consent. Goldstein Dx the rectocele on 2018-06-12 but we never discussed, as it was not a problem. I consulted with Goldstein only for treatment of the cystocele. 

I had no complaint about a rectal prolapse. Goldstein offered me three options for correction of bladder prolapse. A cystocele is a prolapse of the bladder, while a rectocele is a prolapse of the rectum. These are separate complaints with individual codes and very different treatments. I consented to treatment for the cystocele but not the rectocele. That was never discussed and I sought no treatment for a prolapsed rectum.

I chose to move forward with the surgery to correct my prolapsed bladder, not rectum. A rectocele is not a bladder condition or uterine prolapse, and is not associated with urinary incontinence. The rectum is posterior to the vagina, while the bladder is anterior. Very different parts of the body. Surgical corrections for prolapse of these organs involve very different procedures. The cystocele repair Goldstein and I discussed involved a simple suspension of the uterus from the sacrospinus ligaments: no external incisions, no tissue removed, as Goldstein promised. Rectocele repair requires external incisions and removal of healthy tissue, both of which Goldstein specifically promised would not occur. 

As Goldstein noted in the record, I consented to the sacrospinus ligament suspension for uterine prolapse (twice). The rectocele was not a complaint, not discussed at any time, and no recommended repair was proposed or agreed to. Aside from the possible cytoscopy, no other surgical procedures were discussed, mentioned, or consented. Goldstein treated the rectocele without discussion, proposed treatment plan, explanation of risks and recovery, or consent.

During the period between his decision and the surgery, Goldstein unethically withheld that he had decided in advance of my hospital admission to perform the two non-consensual procedures. Goldstein thereby willfully and premeditatively denied my agency. I did not agree to treatment of the rectocele; the genital cutting was forced upon me through medicalized sexual violence.

Goldstein did not correct my problems, he greatly exacerbated them. My overarching problem is PTSD due to too many men in positions of power who incapacitated me and did what they wanted to my genitals without consent and got away with it every time. As you might be able to imagine, this causes tremendous distress in a person. It’s especially distressful when the perpetrator actually cuts a chunk off the junk! The Dr. Goldstein Special gave me far more and bigger problems than it corrected, which will affect my quality of life to the end. 

A person cannot consent to procedures if they are unaware such procedures even exist.  In advance of the surgery Goldstein added the rectocele and two procedures to the order without patient notification or consent, a tremendous deception that deprived me of agency and perineum. He intentionally withheld that he planned to cut my gentials. This is deception. 

“Deception is the deliberate misrepresentation of facts through words or actions in order to make a person believe that which is not true. The forms deception can take include explicit lying, deception by implication, and deception by omission of information that patients need to make decisions in their own regard. Deception intended to advantage the physician economically or otherwise at the expense of the patient is unethical.” –  Deception, ACOG committee opinion: Committee on ethics number 87 — November 1990 

My medical record, summarized in the attached document, “Cystocele v. Rectocele,” shows Goldstein did premeditatively decide to perform the surgery for the rectocele without prior discussion or consent, so he could deliver “The Dr. Goldstein Special.” Every staffer I asked said it takes a lot to gain such a reputation reputation. This means Goldstein has done the same to unknown numbers of women.

The effects of Goldstein’s betrayal are enormous! This doctor did the same as previous perpetrators; he incapacitated me and did what he wanted to my genitals without regard to the person attached. Only, Goldstein did my prior abusers one better: he didn’t just molest or rape, he took a trophy. This is medicalized Female Genital Mutilation, an outrage!  

With his act of immense betrayal and surgical harm, Goldstein severely damaged my health, heavily reduced my quality of life, and disabled me from even obtaining necessary medical care. Due to his abuse, I suffer from Medical PTSD, an iatrogenic condition initiated by Goldstein’s deceit and mutilation of my body. 

As previously noted, Goldstein is the prime reason I continue to be a high utilizer. I had four or five highly triggering visits with 4 different surgeons for consults about the hernia repair and even went through a special perioperative evaluation for vulnerable patients, but could not go through with the surgery due to the terror caused by Goldstein’s heinous betrayal. HHO paid for those visits despite my inability to follow through due to the Medical PTSD sparked by Goldstein’s non-consensual cutting of my genitals. 

At the current rate of my recovery it will be years of work and expensive specialized therapies before I can regain my sense of trust the medical system, and trust in major surgery in particular. I will need many more visits with providers than usual in order to build a sense of trust. Due to delayed detection and treatment I may unnecessarily develop health problems that need a higher level of care because thanks to Medical PTSD I cannot tolerate routine screening like mammography, Pap smear, bone scan, and colonoscopy.   

Also, I will continue to need special care as I can tolerate it, such as much more therapy and likely specialized pelvic PT. Given insurer costs associated with bad medicine, it behooves HHO to sanction and banish unethical doctors like Howard B. Goldstein, DO.

To reiterate, a bladder and a rectum are two different anatomical parts, a cystocele and a rectocele are separate conditions with differing treatments. I consented to treatment for the cystocele, but not the rectocele, which was never even discussed. The procedures for the rectocele were performed without consent. This is highly unethical according to every reliable source, and should be considered so by anyone involved in healthcare, including insurers who pay for extensive recovery. 

As far as I can tell, Goldstein simultaneously committed Medicaid fraud. He performed surgery on a patient for a condition that was not a complaint. It was medically unnecessary and against the patient’s wishes and best interests. Fraudulent!

What do you want to happen as a result of your grievance?

I want HHO to recognize the truth: this was NON-CONSENSUAL SURGERY, highly unethical. I want my insurance carrier to do everything in its legal power to stop this malignant narcissist in a surgeon’s coat.

I want HHO to take all possible action against this provider and the hospital that not only protects him but fosters his development as a predator. The hospital did not have appropriate patient safety measures in place or this man–whose combination of consensual and non-consensual procedures is so oft performed it’s known as “The Dr. Goldstein Special”–would not have perpetrated his medicalized genital mutilation against me.

HHO has the responsibility to its members to take action against unethical providers like Howard B. Goldstein, DO. I seek accountability for the violation of my agency by declining the consent process for the medically unnecessary removal of healthy tissue from my genitals. I want my health insurer to stand on the side of facts, ethics, and patient safety, and agency. 

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