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The Easiest Way to Reduce Spend on Surgery.

This Article will be talking about surgical consultations and the impact they have between both the surgeon and the patient. A good surgical consultation can save a patient’s life and could easily prevent a patient from getting unnecessary surgery done

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     Have you ever wondered why time value of money is crucial in everyday life? Time Value of money is also a very important concept throughout this article. It is important to understand its meaning, and its importance to fully grasp why surgeons should be charging more for their consultations moving forward.  To make things easier let’s define time value of money in simple terms. The same amount of money is worth more now than it may be worth in the future. This is due to the potential it has of earning even more money with it. Fernando, 2023, stated that “Another example, say you have the option of receiving $10,000 now or $10,000 two years from now. Despite the equal face value, $10,000 today has more value and utility than it will two years from now due to the opportunity costs associated with the delay. In other words, a delayed payment is a missed opportunity.” Furthermore, there are some key takeaways to keep in mind when discussing time value of money is (Fernando, 2023):

  • The time value of money means that a sum of money is worth more now than the same sum of money in the future.

  • The principle of the time value of money means that it can grow only through investing, so a delayed investment is a lost opportunity.

  • The formula for computing the time value of money considers the amount of money, its future value, the amount it can earn, and the time frame.

  • Inflation has a negative impact on the time value of money because your purchasing power decreases as prices rise.

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(Ambulatory surgical center market expected to hit USD 235.3 million by 2033, 2023)

1.0-Introduction

     This Article will be talking to you about surgical consultations and the impact they have between both the surgeon and the patient. It’s no wonder that a good surgical consultation can save a patient’s life and could easily prevent a patient from getting unnecessary surgery done. Visa Versa, a poorly done surgical consultation could end up putting the patient’s life within harm’s way during the surgical procedure. During this article will be hitting on points such as what to expect at a surgical consultation and why are surgical consultations important. The article will address how surgeons are financially compensated, and how their compensation structure causes surgeons to charge for consultations which may not be a bad thing. As you will continue to read you may discover there could be a correlation between the price of the surgical consultations and the number of surgeries done. Surgeons who charge more for consultations may have an incentive not to always proceed with the surgery if they find it unnecessary.

     On the other hand, what if the surgeon who performed the preoperative consultation did not get fairly compensated for that consultation? This might provide the incentive of pushing the patient towards a surgical procedure they might not necessarily need or at least might be fine without. Who would have thought that adding such incentive to surgeons would cause the number of surgeries to go up year by year? If you reached that conclusion alone well good job because there is a chance you may be right. Lets dive deeper into this matter and discover the truth about surgical consultation cost and surgery rates.

1.1 What is a Surgical Consultation?

     You might not necessarily know what to expect from a preoperative surgical consultation with a surgeon. Which is completely fine, as you may well know surgery is vastly complicated and its easy to get lost in all the medical jargon, so here is my attempt yet again to make it easier for you.  The main function of a surgical consultation is when the surgeon analyzes the patient's blood work, imaging examinations, electrocardiograms, a full review of the patient’s medical history, and perform a physical examination if needed (Dr. Chacon, 2023). All this is done to ascertain the physical well-being of the patient and his likelihood of withstanding any given surgery (Dr. Chacon, 2023).

     During the consultation, the surgeon will also discuss all the available treatment plans with the patient and in some cases the treatment plan may even include non-surgical options to avoid the stress of surgery entirely (Dr. Chacon, 2023). Based on this evaluation there will be a recommendation given to the surgical team on how they should best proceed with the surgery and the anesthetic type to be used during the surgery (Dr. Chacon, 2023). So just in case you were thinking to yourself are surgical consultations really that important? I hope you just got your answer right there. Surgical consultations can quite literally save your life, save your money, and leave you feeling all safe and content. On the other hand, though if done in a hurry without the proper care being administered it can lead to quite horrible outcomes, I’m sure we would all like to avoid.

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Check out this timeline that illustrates the timetable a regular consultation may take.

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     As you can see in the above diagram the main consultation happens for a brief 30 minutes, the rest of the hour is spent on tests and examinations. Meaning patients are spending around 30 min of the consultation not doing much. This is another issue that presents itself. Surgeons should be checking on these files and tests before the consultation even starts so that when the patient gets there all they need to do is take a quick 30 minutes to discuss the surgical options or treatment plans available. By doing this surgeons waste less time and give themselves more time to have additional consultations during their regular work day. By having this new influx of time surgeons are afforded the opportunity to make more money daily by increasing the number of consultations they can do per day.

1.2 Why Are Surgical Consultations Important?

     You may find yourself wondering why are surgical consultations even important in the first place and are Surgical consultations are important for many reasons? The most important reason would be to make sure that the patient is getting the surgery they need and that they really need it. By using all the information collected and analyzed during the consultation the surgeon will be able to make a surgical plan that is tailored to the patient’s needs (Wijeysundera & Treggiari & Thilen, 2016). In some cases, during the consultation the surgeon may discover that surgery is not needed anymore and there could be other alternatives given to the patient as well (Wijeysundera & Treggiari & Thilen, 2016). Patients are able to ask all the questions they would like about their condition and treatment plans and are able to form a connection with the surgeon that will be performing the surgery that will help establish trust between the patient and the doctor which is very important for the patient before surgery (Wijeysundera & Treggiari & Thilen , 2016).

2.0 Surgeons Financial Compensation.

     There are many factors that weigh in on how a surgeon is compensated, “These components come together in an X-Y-Z compensation model, where X represents the physician’s base salary according to academic rank. The Y factor is a supplemental base salary amount, the product of the physician’s specialty, rank, and clinical productivity. Together, X and Y represent the physician’s total base compensation. Finally, the Z component represents incentive bonuses, which are awarded for clinical productivity, quality and academic accomplishments to faculty who exceed external performance benchmarks. For surgeons, incentive bonuses are tied to completing the wound classification at the time of surgery and in critical care by CLABSI (central line–associated blood stream infection) rates, as well as surgical site infection rates in colon, hip, knee, and spine operations. Finally, surgeons are evaluated according to rates of cardiac mortality and kidney injury after cardiac surgery, for physicians employed by the foundation, there are five primary types of compensation: base compensation, bonus compensation, compensation for administrative time, paid time off and benefits. Base compensation guarantees physicians their lowest salary and is set by each specialty within the organization (Vlessides, 2022).”

Given these factors of compensation, I think we all must agree that this trend is becoming unsustainable due to the fact that government payors and commercial payors both are shifting towards value and volume (Vlessides, 2022). This in turn means surgeons would need to operate more and give higher value for the same amount of compensation, which will not be viable long term. This starts to force surgeons to search for other means of compensation for their services, this may also cause surgeons to book more surgery’s that are not necessarily needed for the patient while there might be non-surgical options available, the surgeon will still push towards surgical intervention due to the compensation structure. If you were a surgeon and you were asked to double your workload, increase your working hours and all for the simple price of no extra compensation, how compelling would you find that offer? I bet you probably wouldn’t enjoy it and probably wouldn’t even entertain it. I know I wouldn’t. That is why a change must happen.

     You’re probably also wondering how much do surgeons make per consultation. A very valid question and quite important as well. However, giving you the answer is a bit more challenging unfortunately. You see there is no fixed rate apparently for surgeons and their consultations fees. It varies greatly depending on which plan you’re on and which provider you are going to as well. For Aetna, Cigna, and United Healthcare consultations fees vary from anywhere around 31$ and 184$. As you can see the discrepancy between the two numbers is quite significant. It’s really something no one can ignore, why would one patient go to a doctor and pay 180$ for the same consultation another patient gets for 31$? Many questions arise from the cost of the consultations however one thing is for sure, surgeons should be on average paid more for these consultations, and as you continue reading below you will find out why they should be.

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