About $1,000.
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- Suspicion of a "kidney cult" halts a transplant
- Surgeons talking to non-surgeons
- Buying a kidney
- Kidney Disease
- Transplant tourism
- Proposed price per kidney
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Wow, he should have been a Urologist. Mine got $750 for my 15 minute Vasectomy.
Dan, A kidney transplant surgeon is a Urologist with extra training in kidney transplantation.
He should have been an orthopedic surgeon. My surgeons bill alone, not hospital or operating room bill but just the surgeon’s bill for doing arthroscopic knee surgery (partial medial meniscectomy and chondroplasty) was over 5,000.00. He billed it as two separate surgeries over 2,500.00 each. I was in surgery about 30 minutes, if that.
“Dan, A kidney transplant surgeon is a Urologist with extra training in kidney transplantation.”
Er, plus the extra years on top of typical residency to actually become *a surgeon.* Surgeons are more than MDs who cut people open once in a while.
“I was in surgery about 30 minutes, if that.”
Billing by time isn’t the best measurement of how much something should cost, but rather were you willing to trade that money for the improvement in your health.
$5,000 to have improve quality of life drastically is a pittance.
(Not saying that you were complaining, but just saying in general people look at things from the wrong perspective…)
I’m a urologist who gets paid maybe 1100 dollars by medicare to perform a partial nephrectomy (removal of a portion of a kidney for cancer) — a technically challenging and risky operation that can take 3 or 4 hours. Also there’s a 90 day global–all the care for the next 90 days is free care. In addition, my partner will spend those same hours helping me, and medicare pays less than 200 dollars for his portion.
Our office overhead per business day is 3 to 4 thousand dollars. So
when we do big cases we actually lose money. This obviously is not sustainable over the long run. The bottom line is now most surgeons make more money seeing a lot of patients in the office and lose money when they operate. With these disincentives the future is pretty bleak for surgery.
While the “extra years of training” sounds like a plausible explanation regarding exorbitantly high orthopedic surgeon fees, it is a red herring. There is no legal document, theory or statute that equates X years of education with Y dollars of compensation for the performance of a particular service. The simple fact of the matter is that there is insufficient competition secondary to a lack of supply of providers for the existing demand to place any market pressure on the fees of the orthopedic surgeons. The auto mechanics that service my cars in a competent manner to ensure my quality of life when I am operating said vehicles do so at a rather reduced cost when compared to what similar piece of mind and quality of life costs in regards to healthcare services. The difference is that there are a substantially larger number of auto mechanics competing for customers and thus driving down the cost. Financial compensation, especially for surgical specialties, is the highest in the US when compared to any other country in the world. There is a reason for this – simple economics, which is independent of years of provider training and procedure quality (when compared to other first world nations).
“Billing by time isn’t the best measurement of how much something should cost, but rather were you willing to trade that money for the improvement in your health.”
This comment scares me a little. So if a fairly easy and quick procedure might save my life, I should be willing to pay whatever dollar value I put on my life? That’s like demanding a ransom in return for your patient’s health, isn’t it?
In response to Anon 4:26
“Financial compensation, especially for surgical specialties, is the highest in the US when compared to any other country in the world.”
You obviously have no clue what surgeons are getting reimbursed. Fees continue to decline with no end in sight. You’ll only figure it out some night when you need the services of a neurosurgeon or an orthopedic surgeon, but need to be transferred to a hospital 100 miles away to get the care you need because of the dwindling number of surgical specialists. Surgeons are retiring at younger and younger ages due to reduced quality of life and incomes. There is no denying that.
Anon 5:48
What is obvious is that you have no idea as to what I know regarding surgical specialty billing. The other fact that is obvious that your straw men arguements failed to address the comment from my original commentary. Can you cite a single first world country in which after-expense compensation rates for surgical specialties is greater than for surgeons domestically? You see, that would be addressing my comment.
As far as the scare tactics go… please save the playbook pages from the New Jersey Medical Association for the segment of the populace that doesn’t realize that they no longer have to (nor did they ever have to) tolerate physican blackmail when it comes to access to care and payment for healthcare services. As far as quality of life goes, you might have a point. As far as income goes, perhaps surgeons are earning less income than they did in earlier years (not the same as earning less than their foreign practicing counterparts) but they are still making a mint over almost any other profession that they could be involved in.
What a surgeon BILLS and what he gets PAID are two entirely different things. Unfortunately, the nature of EOB’s (explanation of benefits) as distributed by an insurer to the insured is such that this distinction is blurred. The insurers like it that way, because it continues to give the impression that the rich spoiled doctor is the bad guy, for charging ten thousand bucks for a sinus surgery, for example. What they don’t want the patient to realize is that the insurer only paid two hundred bucks, and the deductible met by the patient was perhaps another three hundred, and the surgeon accepts that amount contractually as PAID IN FULL.
Here we go with the same anonymous troll again, who has no clue that healthcare in the USA is NOT a free market entrerprise.
NYC and Boston have the most number of docs per capita of anywhere in the world.
According to anon’s ridiculously simpleton logic, that means that NYC/Boston docs should get paid the least right? After all, they are in a crowded market with lots of other docs.
But of course thats NOT the case. NYC and Boston docs are some of hte highest paid doctors in the nation.
One would think that if you are going to spend the time posting, that you would spend a bit of time reading the response(s) to the same. Let us try this again, but let us do so in a simple manner to not loose you. Let us say that 5,000 doctors are needed per certain plebeian population count in order to engender a competitive environment. If region A has 300 doctors (under the same plebeian population metric) and region B has 500 doctors (under the same plebeian populatio metric). What does this tell us? It tells us that region B has a higher provider count, per plebeian population metric than region A. Does it tell us that there are enough providers to make it a competitive environment? No. Do you understand yet or do we need a simpler explanation for you?
“You obviously have no clue what surgeons are getting reimbursed. Fees continue to decline with no end in sight. You’ll only figure it out some night when you need the services of a neurosurgeon or an orthopedic surgeon, but need to be transferred to a hospital 100 miles away to get the care you need because of the dwindling number of surgical specialists. Surgeons are retiring at younger and younger ages due to reduced quality of life and incomes. There is no denying that.”
Surgeons are compensated at an average of $250K per year. Cry me a river. Not saying they don’t deserve it, but don’t expect too much sympathy. They are retiring early because they can afford to. If only we were all so lucky.
Ok lets talk quality of life. I was the poster with the artroscopic surgery on a knee. I had a very unstable knee, locking up, callapsing and constant pain from more than 2 decades of OA. There were x-rays and also MRIs indicating severe medial compartment OA, with tears and several other things, osteophytes, cysts, chondromylasia and etc..
The words meniscectomy and chondroplasty sound like big words, but in fact they take what seconds, minutes to perform.They consist of running a punch and shaver over the area. The Surgeon receives 5,000.00 for those few minutes, but did it improve my quality of life?
I never took one painless step following this surgery. All attempts at PT were failures and I soon couldn’t even return to work. Within one year I had a total knee replacement. In addition to charging as 2 separate surgeries (still talking arthro. surgery) the hospital also billed for 2 separate uses of the OR at 2,700.00 each. So now we are at over 10,000.00 for a few minute surgery (1 surgery not 2).
I have to say, no improvement of life here following that arthroscopic surgery. It was a totally useless surgery.
9:48,
How much do you weigh?
12:05 I am 5ft 3in and had weighed 134-138lbs. for many years. I very recently started prednisone and have gained some. At my Doc’s last week I was 144 lbs…All in my face, I think..:)
BTW, in case your interested, I’m also female, divorced, have auburn hair, drive a honda accord and own my own home…lol.
You could see where this was going? They were going to blame the patient for the failure of the surgeries. If the surgeries had been a sucess then the provider would have been a miracle worker. Since they were a failure, its the patient’s fault.
12:29, yup!
Are you guys certain that some of the ins. problems aren’t with your own billing or acccounting personnel?
You talk so much about billing ins. and only getting a ridiculous reduced payment. I keep all my ins. statements and this is exactly what was billed and what was paid.
I’m the arthoscopic surgery BTW.
Surgeon billed:
2708.00
disc= 541.60
my co-pay=433.28
ins. paid=$1733.12
Surgeon also billed; (2nd. part of SAME surgery;
2452.00
disc=490.40
my co-pay=392.52
ins. paid=$1569.28
total surgeon received was $4128.2
Orthopedic ins. chg. for surgery
2694.00
2694.00
337.00
43.66
discounts equaled 1442.16
I had met my co-pay for year=0
total paid by ins.$4190.78
in addition Surgeon also sent a bill for $990.00 I don’t know what for??
ins paid=$792.00
total that ins. paid was=$8285.18
total I pd. in cash=$825.60
total amt paid=$9111.20
I don’t know but I can’t see where there could be a complaint if you are receiving those type payments for a few minute surgery and honestly, it looks to me to like everyone billed and got paid double.
Additionally, there was later another bill turned in to my ins. for the same amt as above with an addition charge of $1,190.00
He was paid 940.00 and the rest was denied for claims that had already been processed and paid.
It would be kind of sad if something was happening to his money and all he saw was the check for 940.00 and believed that is all that was paid. Otherwise I can’t see any basis for your complaints.
What I don’t understand is who is getting blamed here for this surgeon only getting 1,000.00 for the kidney transplant.
This sounds to me like the surgeon was probably on salary through the university. Alot of the big universities surgeons and doctors are on salary.
The story admits that the ins paid more than 100,000.00 for this surgery.
It sounds to me like an internal dispute between the surgeon and his employer. But, I guess it makes a good story if ya don’t read to closly.
Peyton Manning received a 34.5 MILLION dollar signing bonus for throwing a football. Nobody says a word about it. He plays for a couple of hours on a sunday. Surgeons not only go to school for years, they also save lives on a daily basis. I played football as a kid, not anywhere near the level of pro, but I have played. I do not have the technical ability to do anything close to what a surgeon can do.
What troubles me more than anything else about these arguments is the lack of wisdom in them. The argument basically involves two main points:
1. Surgeons spend little time in procedures that are deemed relatively simple and they charge too much for them.
2. Surgeons are getting paid more than they deserve because of 1.
Simplistic explanations via economic jargon and over simplyfing the job of a surgeon does nothing to explain the full story. The idea of what it takes to be a surgeon, or for that matter a physician in general, is thrown out the window in all these explanations. Nobody will deny that it takes 4 years of medical school, and another 5 years of residency plus 1 or 2 more years for fellowship to attempt a surgical subspeciality. However, people will ignore what that entails.
The reason why the procedure is “simple” is because the surgeon took 10-11 years of his life making sure it would be “simple”. You are paying the surgeon $5000 because HE is making it simple for you via his formal education and experience. Otherwise, you could go to the local butcher and let him take a whack at it, but I doubt any of you would do that =)
This is the same reason why the car mechanic analogy is flawed. Yes, in very simplistic terms you can explain everying by supply and demand, but does that explain the situation completely? No. In fact, it’s fairly insulting to most intellects to even answer with such a simplistic statement. Car mechanics neither require the formal traning a physician needs, nor do they deal with situations as big as doctors do, namely life.
Although I agree healthcare is expensive, I think it requires a little perspective. People are willing to pay $5000 for a new home entertainment system, or rarely object when they see David Becham sign a $250 million dollar deal to kick around a small round object into a net, but when it comes to their own personal health, their life…well….”those damn surgeons!”
I agree with the previous post but would like to add an anedote. Sometimes things are best explained by simpler words =)
A doctor goes to his mechanic to pick up his car. The mechanic takes the doctor to his car and says, “See doc, I fix complicated machines, and you fix complicated machines. I have to figure out problems and so do you. I replace and mend, so do you. So tell me doc, why is it that you get paid so much more than I?”
The doctor smiled and said, “Try to do it while the car is on.”
oh my word, if you would like to have a bad doctor and only pay 500$ and in the end, having to pay more because say he messed up or forgot to do something? wouldnt you rather just pay 1,100$ for 1 time deal instead of going back…
From a Surgeons Wife:
Reading all of your comments is truly making me sick to my stomach. I am a nurse – in a good year I make well over $100,000. My education consisted of 2 years of college and 3 months of orientation to an emergency dept. My education cost approximately $10,000 which I easily paid back in my first three months of working. My husband is a Surgeon.
We met in his second year of Surgical Residency (5 yrs total). When we met he was working well over 100 hours per week and came home with a whopping $1,100.00 bi-weekly. He never slept, we barely saw eachother and I paid most of the bills. Fast forward to completion of his residency. We had to pay for all of his licenses, applications to hospitals, and lets not forget $35,000 for medical malpractice before he even performed a surgery. Now, in his second year we are paying $55,000 for medical malpractice and on most busy nights 30 – 50% of his patients are either uninsured or medicare which might pay $200- $600 depending on the surgery. He dedicated 4 yrs of his Ivy League education, 2 yrs of Research, 4 yrs of medical school and 5 yrs of Surgical Residency to his practice and to helping others. We are now in the process of paying back his $350,000 in school loans which acquire interest from day one. Our phone rings in the middle of the night almost every night that he’s actually home. He makes himself available to his patients and his hospitals 24/7. We have missed countless events and have left numerous family functions including weddings on behalf of his practice and his patients. We will soon be receiving his new malpractice bill which will most likely be in excess of $70,000 for his third year of practice. He can be sued by anyone at anytime whether they had insurance or not. Have any of the posters who so quickly make comments about how Surgeons make $250,000/ year ever dedicated 15 continuous years of their lives to any type of education? Do you really believe that $250,000/yr is worth what my husband has gone through and the bills he has accumulated? Unlike a hospital bill we have to pay back this debt or we will lose our home. As I said earlier I am a nurse and I do work very hard but I would have never endured what my husband endured to make $250,000 per year when I make over $100,000 working half as much as him with my measly 2 year education. Think about that the next time you question a bill sent by a man who woke up in the middle of the night and went to work on saving your life whether he would be paid or not to do it- then thank God there are people like him
This is actually funny my mother in law was talking to me a few days ago about a partial nephrectomy and the reimbursement is ~$1300 with a 90 day post op. I was talking to a surgeon and he explained the more procedures you do in one surgery the less is worth it for you. He claimed that procedure 1 he will get 100% reimbursement and every subsequent procedures in the surgery he would get 25% reduction of the prior procedure.
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