Differences between third-party-reimbursement and payment-for-service

A recent article said patients were surprised to be asked to pay more than an insurance co-pay when visiting their doctor for medical services. They were being asked to pay the full amount they were responsible for at the time of their visit. After that, the doctor's office waited on delayed partial payment from the insurance company.

This is an issue in third-party-reimbursement situations, but not in pay-for service medicine like cosmetic surgery. In this field, a patient decides on a procedure they wish to have done, schedule their procedure, pay the costs, and have the procedure. Routine post-operative care is included, so there are no charges for the subsequent visits.

While it's nice to wait and pay for something later, payment at the time of service (for elective or scheduled care) is most logical and least expensive. It makes little sense for the practice to wait months and mail out bills for care patients received long ago. Contrary to the article's report, many medical offices figured this out years ago and follow it routinely. This reduces costs.
http://online.wsj.com/article/SB10001424052970203674704574330354250207192.html

Items in the media

Some recent online articles about cosmetic plastic surgery.


http://www.theweekender.com/cover/One_lift__tuck_or_suction_at_a_time__cos_07-28-2009.html

http://www.healthywomen.org/blogs/midlifematters/2009/07/lines-and-wrinkles-be-gone.html

Funny Names, Sad Commentary - "BoTax," "Tummy tuck tax," "Vanity tax," "Nose job tax"

Today various news outlets are reporting that the Congress or Obama administration are proposing sales or excise taxes on elective cosmetic procedures. This might include cosmetic surgery, non-surgical cosmetic injections, laser treatments, and others. It might also include Lasik vision correction, tooth whitening & hair transplants.

Lawmakers and interest groups pushing expanded government health care proposals are responding to revelations that their proposals will be much more expensive than they initially claimed. They are having to come up with taxes that appeal to a broad majority, even if they unfairly take from significant minorities of citizens.

If folks want these expensive programs, they are going to have to have major new taxes to pay for them. It is sad that proponents of reforms haven't been able to propose broad taxes that take from all that will benefit from the proposals. Why not simply raise general revenue tax rates on everyone. Narrowly focused taxes are politically more palatable, but create ever more complex tax laws and enforcement bureaucracies. They are fundamentally unfair.

www.nbcwashington.com/.../Bo-Tax-Dems-Contemplating-Cosmetic-Surgery-Tax.html
http://www.guardian.co.uk/world/2009/jul/28/healthcare-obama-tax-cosmetic-surgery
www.taxfoundation.org/blog/show/536.html

Safe Surgery in the News

Recently the Wall Street Journal ran an article stressing the importance of safety and accreditation in office-based surgery (including cosmetic surgery). (July 21, 2009) We couldn't agree more.

The article highlights that many facilities lack oversight, regulation, etc. Potential patients should be aware that the American Society of Plastic Surgeons saw the importance of facility accreditation several years ago. The ASPS requires that all of its members only operate in accredited facilities. Members are also board-certified in plastic surgery.

Our office surgical facility was carefully designed from the outset with safety in mind. It has been nationally accredited from the beginning by the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF). This includes annual review, on-site visits, staff training and certification, back-up equipment and safety systems. Our facility meets or exceeds state laws and regulations. All anesthesia is performed by our board-certified MD anesthesiologist. All OR nursing and physician personnel are Advanced Cardiac Life Support certified (ACLS). http://www.expertplasticsurgeon.com/html/about.html#nationally-accredited-facilities

http://online.wsj.com/article/SB10001424052970203946904574300971306299860.html

Finding A Good Plastic Surgeon: Article in LA Times

See a recent article in the Los Angeles Times http://www.latimes.com/features/lifestyle/la-ig-plasticsurgerybox19-2009jul19,0,1952565.story

Nine Secrets to Longer Life

1. Move: find ways to stay active
2. Plan de vida: build your purpose in life
3. Downshift: take a break occasionally
4. 80% rule: don't overeat, stop at 80% full
5. Plant power: choose greens in your diet
6. Red wine: glass a day
7. Belong: stay social
8. Beliefs: get ritualistic
9. Your tribe: family matters

These are a summary of the recommendations of Dan Buettner. He wrote The Blue Zones: Lessons for Living Longer From the People Who've Lived the Longest (National Geographic publishers). This work came from living with and studying people in Sardinia, Okinawa, Costa Rica, and Loma Linda, California. If you're interested: http://shop.nationalgeographic.com/product/955/4264/110.html

We can all easily make use of some of these principles. Healthy and happy life is a universal goal.

Diprivan (Propofol) in Plastic Surgery: Safe usage vs. Michael Jackson in the news

Safety in surgery and anesthesia are extremely important to us at the Aesthetic Center. We have a nationally accredited in-office surgery facility with all anesthesia provided by our board-certified physician (MD) anesthesiologist. This facility and its staff is unique in the Carolina upstate. http://www.expertplasticsurgeon.com/html/about.html#nationally-accredited-facilities

The news about the death of performer Michael Jackson has included mention of Propofol (diprivan) a potent sedative normally used in anesthesia, being used for insomnia treatment by a home care physician. We do not want adverse news or mis-information about this medication to cause concern among our patients or the public. For those that want more information, we suggest a website rxlist.com. http://www.rxlist.com/diprivan-drug.htm

It's FDA approved uses are induction and maintenance of general anesthesia or monitored anesthesia care, and sedation of intensive care unit patients on breathing machines. The usage in our facility is according to FDA approved guidelines and accepted standards of anesthesia professional care.