As a practicing doctor, it’s incredibly frustrating to me that insurance companies, most are for-profit entities. So patients are having higher premiums, they’re paying into the system, and that they come in and they’re incredibly frustrated that whatever they need is not covered, and they say, but I have insurance. And they don’t get that the motivation of the insurance is to keep as much profit as possible, isn’t necessarily.
Business people are running medicine, not doctors. A business person can get in the head of all healthcare providers making all these decisions, but also even convince, quite frankly, a doctor who probably went into the field of medicine for the right reasons, spent a better part of a decade training, but then dangled this: okay, you use this, we’re gonna cut you an extra $10,000, the more you, to the point where they literally do sham surgeries and ruin people’s lives.
I was approached first when I started my practice about ten years ago, nine years ago. It was early on. I was approached by this gentleman saying that, okay, these are the screws. If everybody uses all these screws, we all make money, and the more you use, the more we make money. And with the other surgeons, if you guys all use it, minimum ten thousand a month to forty thousand a month, automatically, just like that. And it’s been shown that, you know, that some of the physicians who uses, all of a sudden the rate of surgery and fusion goes up.
Now greed, you know, can cloud your judgment.
30% of Medicare spending is estimated goes to care that is unnecessary or harmful. And we live in a country where we talk all the time about we don’t have enough money for health care. We spend more money on health care than any other developed country in the world, and we have these, some of the worst health care outcomes, and why? 30% of Medicare spending is, 30% of Medicare spending is unnecessary or harmful, and yet no one’s talking about this. No one’s talking about this. Part of that Medicare spending went to this doctor who ruined people’s lives.
So I want to ask you this, in your, in not just your field, but in general.
I think it’s actually at a point where the onus has to be a little bit more on patients, because I think we’ve been naive.
Educating the patients. I think one of the main things all the patients can look into is go where you wanna have surgery, talk to the nurses. The nurses have seen it all. You know, they have seen multiple spine surgeons, same procedure. They can talk to you about the outcome and give you their honest, honest belief about what is going on. Get references. If you cannot get three references from a doctor, that’s a problem. And the other thing is that ask the doctor, are you financially, you know, benefiting?
And I think if someone’s also rushing you into a procedure that really should be elective, right?
Spine surgery, we’re talking spine surgery here, spine surgery is most of the time, thank God, it’s elective. On this, your, your arm is so weak, or your leg, you know? You know that you’re very weak and something bad can happen if you don’t have surgery. But that’s very rare. Most of the times you’re having surgery because of pain, and pain is non-emergency.
And the good news, I will say, is we have some of the best spine surgeons in the world in this country that can do amazing things. So kudos to all those docs out there doing those things, and doing it the right way, doing it ethically.
Hooman, he offered non-surgical options first and left surgery as the last resort and gave options.
Most of the time, I have had some patients who’ve been told they need emergency surgery. They’ve seen me, I get every other week, I see a patient has been told they need surgery next week, and most of those patients don’t even need surgery. Now they’re told they need emergency surgery, like they needed a surgery in a week.
Well, we’re all learning as we go here. Dr. Melamed, thanks for being with us.
