Blog Entry Details

• Physician Financial Woes Lead to Problems for Plastic Surgery Patients

  By Dr. Jeffrey J. Roth Wed, February 15, 2012 2:51 pm MDT

  Recently CNN Money reported on a dangerous and little known trend developing in the world of private practice medicine. Changes in insurance coverage, increased business costs and a tumultuous economy have combined to place physicians in a very precarious financial place. In short, some doctors are unable to bring in enough revenue to offset the costs of running their practice. Perhaps some people will have a cynical initial reaction to this issue: “Oh well, Dr. Smith will have to trade in his BMW for a Honda.” Unfortunately the situation is a bit more serious than that. Ultimately it will affect the quality of care that patients receive.

  As a board certified plastic surgeon who strives to run a successful cosmetic surgery practice and offer all of my patients exceptional care, I’d like to identify some of the causes for this unsettling trend and explain what they mean for patients. Although my immediate experience is limited to the reconstructive and cosmetic health industry, I do believe it is symptomatic of the larger national issues unfolding in health care today.

  In the last several years Medicare, Medicaid and many insurance providers have significantly decreased their compensation towards health procedures. Additionally, the regulations surrounding payments from this type of agency can be a burden. Between appeals, denials and maintaining records to receive payment you almost need a full time staff member to be devoted to monitoring the process. This is not a practical option for many private practices.

  This creates a poor situation for patients as their access to quality healthcare providers becomes limited as some physicians are forced to decline patients who rely on healthcare insurance like Medicare and Medicaid.

  As it pertains to plastic surgery, this situation further compromises patient care as some plastic surgeons are inclined to offer fewer reconstructive procedures and focus their efforts on cosmetic procedures. This decision is strictly financial; many managed health care insurance providers will no longer pay for reconstructive surgery and cosmetic surgery has never been covered. By eliminating reconstructive services physicians can eliminate the billing hassles associated with them.

  Modern medicine is an amazing thing and today reconstructive surgeons have the resources and ability to produce miraculous results for patients. For example, physicians have the ability to transfer tissue from one area of the body to another using a microsurgical technique that connects arteries, veins and nerves. Unfortunately access to these types of procedures is becoming more and more limited as many providers won’t pay for them and surgeons are forced to settle for less elegant, less expensive methods.

  The cosmetic industry is also being compromised by “non-insurance” procedures. Ultimately this leads to patients receiving care from less experienced, less qualified practitioners. Doctors in a variety of specialties are being wooed by medical and health care industry manufacturers to perform “non-insurance” based procedures. A laser company wants to sell its lasers, upgrades and products. In order to do, many companies host weekend training courses or sell official sounding affiliations and certificates with minimal training.

  These “non insurance” procedures create issues for doctors as they place doctors in a position where they are forced to offer less expensive, less refined procedures or face the possibility of losing current and potential patients to other practices. They also diminish the quality of care patients receive as many of these “non insurance” procedures are based on a profit model, not one focused on the actual health and well being of the individual patient.

  These types of procedures also limit patient access to board certified, experienced and professional doctors. This increases patient risk as many of these weekend seminar trained or mail order certified practitioners are not qualified to deal with issues or unforeseen events that can arise during the administration of any procedure. Board certified plastic surgeons with years of training and experience can usually correct health issues if they arise. More importantly, they are trained to identify an issue or risk before it can ever become an incident or threat to patient well being.

  We all know that healthcare is going through significant change in this country. Let us hope we can improve the system to allow qualified physicians to keep their doors open and provide patients with the best possible healthcare they can receive. If we can achieve this everyone will benefit.
   

  Jeffrey J. Roth, M.D., F.A.C.S.

  Las Vegas Plastic Surgery

  702-450-0777

  www.jjrothmd.com

  References:

  CNN

  Tweet « Go Back