I’ve seen quite a bit of media “chatter” recently relating to the income derived by various medical specialists, including Surgeons.
Whilst it is entirely reasonable to have this discussion, there really does seem to have been a dearth of open and honest response from Surgeon’s themselves. So, here is what I have to say on the issue, in the interests of full disclosure. Of course, this is just my perspective.
A Surgeon’s fees, much as for any professional you may consult in life (be it a lawyer, an architect or an accountant), are based on a number of factors: the time required to consider, discuss and plan your treatment; the length of any proposed surgery; the complexity of the required procedure; the skill of the surgeon involved; and the many (many) years of training required to gain those skills. On top of that, there are basic business considerations including the cost of maintaining and running rooms: staff, the costs of consumables such as dressings, and of course the very significant issue of medical indemnity insurance.
Now, what does that actually mean to a patient?
It means that there is almost always some out of pocket cost passed on to the patient. For reconstructive procedures, this out of pocket cost is much less, because where a Medicare item number applies, then medicare and your private health insurance will cover a reasonable portion (if not all) of your costs. For cosmetic procedures, there is absolutely no role played by Medicare in funding surgery. This should be self evident, as we are talking about totally elective procedures performed at a patients request, and not based on need. As such, cosmetic procedures are charged in full to the patient, including hospital fees and anaesthetic costs. There is no getting around this fact.
Honest surgeons performing honest work to the best of their abilities are highly trained professionals, who will charge a fair fee. This is true for any other group of highly trained professionals, and it is no different for surgeons. What continues to surprise me, is the outrage that seems to be so frequently confected by the media, blaming surgeons for the woes of our health care system.
“Honest surgeons performing honest work to the best of their abilities are highly trained professionals, who will charge a fair fee.”
I am not so blinkered as to believe that there aren’t surgeons out there charging ridiculous sums for certain procedures. These individuals seem not to be guided by any particular sense of personal ethics, and of course, there cannot be a way to “force” surgeons to charge only a certain amount (which I should add, is as it should be). Ultimately, private health care remains just another “market” and that market will ultimately set its own price. Of course, we must reflect on the fact that exorbitant surgical fees would not be an issue if there weren’t patients willing to pay.
I believe that surgeons treating patients with conditions such as cancer (whether it be skin cancer or breast cancer) should do what they can to limit the out of pocket costs to those patients. These are not elective operations, and they should not simply be exercises in personal monetary gain. I believe however that a surgeon does have the right to set a fair fee reflective of the issues I have already mentioned above. There are occasions where the fees paid by a private health insurer to a surgeon are inadequate, and there may be instances where a surgeon has to make a pure business decision in setting their own fee. Unfortunately, the Private Health Insurance industry is NOT acting in our patients’ best interests in many instances, and the products which are being offered to consumers are often frankly inadequate. I have commented before on the fact that Reconstructive Plastic Surgery procedures are not covered in the majority of hospital cover policies: we are living in the country with the highest per-capita incidence of skin cancer in the world, but without “top” hospital cover, you won’t be able to access the necessary reconstructive procedures after a skin cancer has been removed. This is a separate issue, but it comes back to the fact that what the private insurers are willing to pay surgeons for is not necessarily a reflection of what our patients need. Therein lies a serious problem, and it is one that can lead to increased out-of-pocket costs being passed on to patients.
“…the Private Health Insurance industry is NOT acting in our patients’ best interests in many instances…”
When it comes to purely elective and cosmetic procedures, ultimately patients must exercise their own judgement in choosing whether to proceed (most especially with regards cosmetic surgery procedures). All we can do is promise that we will always provide a full and frank financial disclosure to our patients (as should any other surgeon) – our patients have a right to make an informed choice.
All of our patients are provided with our fees policy at the time of making their first appointment with us. It is part of the open, honest discussion that I believe is necessary about surgical fees.
Please let us know your thoughts.