The couple's employers, Kaiser Permanente, said that they had been fired a week ago and disputed Lupoe's account of an administrator telling him to "blow his brains out".

Heavy smoking in midlife more than doubles your odds of developing Alzheimer's disease, a Kaiser Permanente study said Monday.

Instead of letting patients go straight to a specialist, managed-care firms like Kaiser Permanente make them see a primary-care doctor first, who will figure out whether the problem is serious.