Thanks for enlightening us on the $640. I knew the fee was low but that is ridiculous. I also know that they pay closer to $200,000 a year for malpractice insurance - each!
Have a wonderful, painfree day! Dee
At Sat, 10 Mar 2001, Mary Wade wrote:
>
>Dear Friends
>
>There is a reference book that health care providers can use to figure
>out what they can expect to be paid from insurance companies for medical
>procedures in the US. Prior to my Dec 15 surgery with Drs. Reich and
>Redan, I looked up what that average pay-out (based on Medicare rates)
>is for adhesiolysis. I about fell out of my chair! $640!!! I had heard
>some adhesiolysis surgeries in Scranton have taken up to ten hours. That
>was a moment of truth for me. That "$640" told me why there are not
>surgeons for us. If we are looking for a battle cry....this is it! Hang
>with me on this one. Let's look at it.
>
>Do the math. Take that $640 and see how far it goes. Pay the office
>staff. Pay their benefits and employer's share of FICA. Pay the
>professional dues. Pay the rent and the utilities. Pay the many many
>thousands of dollar in malpractice insurance (and any doc who wants to
>work with us is going to pay huge premiums...$50000-$100000 per year, I
>would guess....because we are so high risk). Think there is still of
>money left over? If so, then you have never run a business. If I spent
>years in medical school, would I choose a career path that would promise
>minimal compensation with maximal headaches? Nope...not me. There are
>bills at home to pay, too.
>
>So let's look at my adhesions treatment options. 1) I get all my care
>at state-subsidized teaching facilities (i.e., medical schools).
>Students there have to log their "hours" doing surgery. Hmmmm....wonder
>which student would be getting their hours on me. Even the clumsiest
>student needs his/her hours. 2) I do not seek a surgical solution. What
>a difficult situation I am in to know instinctively that the only "cure"
>for me will be surgery...but to also know that surgery is often the
>cause! 3) I find a surgeon who does a lot of different types of
>surgeries so that the compensation she/he gets for those other surgeries
>can help counterbalance financially what they get from my procedure.
>This route means that they would not have specialized in adhesions. I've
>never met another person like me in real life. So, how common is my
>predicament? How often would this doc have a patient like me? Any task
>improves with repetition. How often has this doc done "my" type of
>surgery?
>4) I choose the only facility in the US with physicians dedicated to
>working on adhesions. And I pay fees my insurance *should* be paying.
>
>We must recognize that we ARE in a heckava position..but the REAL fight
>that we should be waging is with insurance companies. And that is a
>whole bunch of work and the pay-off....will be years down the road.
>Anyone interested in taking that one on? I am. Let me know and we'll
>make it a goal that 15 years from now, that insurance companies will
>honor our medical needs with their dollars. 15 years? I figure it will
>take that long. $640 is an insult to US.
>
>I suppose it is a whole lot easier to make physicians or their staff the
>focus of our frustration. The risk of this focus is that the PA doctors
>will say "screw this" and their pioneering actions in creating an center
>to treat adhesion patients in the US will have been a "mistake." This
>option for us will go away. Nothing obligates them to continue this
>work. That is a desperate thought for me.
>
>This week, I worked 10-12 hour days...by choice. Today, I will take no
>pain meds. With a clear mind and a happy and joyful heart, I will spend
>the day babysitting for our 2 year-old wild-child granddaughter. We
>will dance. We will go to the park. I'll hold her in my lap and pump
>my legs to make the swing go high. When she runs the other way, I can
>run to catch her. This week...this day...and others like it....is what
>we were shopping for when I went to Scranton.
>
>In friendship, Mary
>
>--
>Mary Wade
>