is it about money?

From: Mary Wade (
Tue Sep 12 06:06:38 2000

I read a sentence or two about how surgeons are paid for adhesions surgeries on one of the sites that Helen found for us. It mentioned in passing that the long hours that the surgeons have to spend to carefully remove adhesions are not reimbursed at attractive rates for the docs. I wonder how big of influence this has on the treatment that we receive. I realize that these may be fighting words for some of you, but as one who works in a surgeon's (not an abdominal surgeon) office, I see how long and difficult surgeries can drain the energy of the docs. It is demanding work. Their arms get tired. It's not glamorous. And then to not be paid well for the time spent? And to be involved is a high risk procedure that often does not produce the desired result, thus setting themselves up for legal action? What, then, would motivate them to do these surgeries? If the "adhesions don't cause pain" stance can be taken, or the patient can be referred on to a pain clinic, or referred on to another doc, then the first doc is perhaps in a better position both legally and financially. We have a book at the office that tells the prevailing rates that insurance companies pay docs for their procedures. I'll have to look and see what adhesion related surgeries pay.

I can see this whole thing so unemotionally from the other side because I work in this setting. It would be hard to see it without emotion if I hadn't been on the other end. It's so rewarding and delightful to work with patients that you can "fix." It's time-consuming and emotionally draining to work with patients who can't get the relief that they want. Human compassion keeps us "being there" for them, and that has its own bitter/sweet (90% bitter and 10% sweet) rewards.

In summary, if I was a doc in the US free enterprise medical system, I wouldn't want me as a patient.

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