What is a highly skilled and experienced surgeon worth?

From: Helen Dynda (olddad66@runestone.net)
Thu Jul 27 17:17:31 2000


In answer to a letter, which I received today, I said: Yes, I understand that Dr. Harry Reich does expect $'s for the initial visit and a pre-payment of $'s for the proposed surgical procedure. I am sure that Dr. Reich would prefer to NOT have to ask prospective patients to make a down payment toward their upcoming surgery; but, unfortunately, Medicare and ALL of the other insurance companies - such as HMO's, etc. - have caused this to be necessary...simply because they have not been fair in the way they have been re-imbursing surgeons for their professional services.

I had a diagnostic laparoscopy August 01, 1997, which was MORE than just a diagnostic laparoscopy. As a result of my diagnostic laparoscopy, my surgeon discovered that I had massive adhesions attaching my omentum to my abdominal wall. He had to deal with lysing ( cutting ) the adhesions BEFORE he could investigate the rest of my pelvic cavity!! He had to do an adhesiolysis...in addition to the diagnostic laparoscopy!!! He very carefully lysed the extensive adhesions, which had formed as a result of the laparotomy I had in 1970...YES, I said 1970!! These massive adhesions had literally and completely glued my incision to my omentum...7" down and 4" across my abdominal wall.!! This surgeon was finally able to CORRECTLY diagnose the cause of my chronic pain, which I had lived with for 27 years!! My chronic pain had NEVER before been diagnosed correctly...until this August 1997 surgery!!!

I am on Medicare...with Blue Cross as my supplement. So how did Medicare reimburse my surgeon, the hospital and the anesthesist? FAR LESS than they should have been compensated!! Medicare ( and possibly all insurance companies ) has a list which gives the $ amount of what they feel each surgical procedure is worth; and it is a list which they never waver from. If a surgery is a diagnostic surgery, their list says that this procedure is worth so many $'s...and NO more. When the diagnostic laparoscopy is a very difficult surgical procedure, such as mine was, Medicare ( and other insurance companies ) pays the surgeon the exact same amount that is paid for a simple diagnostic laparoscopy. It does not matter if the surgery takes less than an hour...or if the surgery takes several hours.

We, who have had surgery for adhesions, know that a surgery for adhesions can take many hours for the surgeon to complete! I watched Bev's video of her adhesiolysis. Dr. Reich was Bev's surgeon. Her surgery took 5 hours!! I also viewed Deb's video, which was also performed by Dr. Reich. Deb's surgery for adhesions took 10 hours for Dr. Reich to complete!!! There is NO way for the surgeon to know ahead of time how much time a patient's surgery will take...and Medicare and all the other insurance companies don't seem to understand this!!

Now, do you understand what has happened as a result of Medicare ( and other insurance companies ) controlling the amounts paid for the various surgical procedures? This kind of control has given surgeons a very good reason to want to be sure that they are adequately compensated for the very difficult, time-consuming, and dangerous job that surgeries for adhesions are. So, to protect their own interests, many surgeons are asking for a down-payment BEFORE the surgical procedure is scheduled. Once the surgeon has been reimbursed by Medicare ( or any other insurance company ), then surgeons may be able to refund part of the down-payment...depending upon the $'s received from Medicare ( and any other insurance company ).

Dr. Harry Reich is recognized as being the BEST laparoscopic surgeon in the world!! For that recognition...a patient of his is going to have to expect to pay more!! This is only fair!! Remember...he is very skilled and very experienced at what he does best...laparoscopic surgery

There are not ANY surgeons who really want to do surgery for adhesions...unless the patient is suffering an emergency situation...such as a bowel obstruction. Adhesion surgeries are very difficult, are time-consuming, require alot of skill, are dangerous for the patient, and can be so very,very discouraging for the surgeon. Why? Because adhesion are the way our body heals itself!! Each surgery will cause even more adhesions to form....UNLESS the surgeon uses every technique he can muster up to be the victor over adhesions. This is what Dr. Reich is able to give to his patients!! He is willing to dedicate his surgical expertise to battle adhesions in the way that he knows best.

If you are tired of taking expensive pain medications to relieve your pain...and still you are experiencing pain...and if you are determined to give surgery a try, BE SURE TO CHOOSE THE BEST SURGEON YOU CAN FIND!! It is the surgeon, whom you choose, who can make the difference as to whether you will have further problems with adhesions!!! There are NO surgeons who can guarantee that your adhesions will not re-form!! BUT the best surgeons will do everything within their power to try to help you become adhesion-free.

Currently, to the best of my knowledge, the only adhesion experts in the United States are Dr. Harry Reich and Dr. Jay Redan...who together opened the very first Adhesions Unit at Community Medical Center in Scranton, PA. Dr. Matthias Korell of Duisburg, Germany shares the spotlight as also being an expert in doing surgery for adhesions. Dr. Korell recently performed an adhesiolysis and a second-look laparoscopy for Mary Pomroy, who had a very severe case of adhesions. Our Bev ( bnb@cybrzn.com )and Mary will have alot of excellent information to share; which will help to make it easier for others to consider traveling to Germany for adhesion surgery.

I hope that I have explained this in a way which will help you to understand why prospective surgical patients are expected to make a downpayment, if they want the surgical services of one of the best adhesion specialists in the world. You, of course, are free to seek the services of any surgeon you want. As for me, I have decided to have Dr. Harry Reich as my surgeon. My appointment date is pending.


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