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The Easiest Way to Reduce Spend on Surgery.

Why you should pay your specialist more for your consultation.

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MORGAN SMITH - ISMAIL KASSEM
5/29/24 - 5 MIN READ 

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To start of lets go over a simple concept that ties in heavily with the theme of this post. Time value of money which simply put means 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 “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.”

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Introduction

Surgical spending is one factor that all businesses are affected by. For example "Health spending in the United States is projected to grow by 5% between 2023 and 2024, to a total of $4.9 trillion". If you’re a business owner you’ve probably run into this problem before and you’ve also probably been flooded with paperwork trying to provide the necessary care for your employees.

 

Theres a lot to deal with no doubt but one thing stands out. By paying surgeons more for surgical consultations it may just reduce your surgical spending in the long run.

Why you should start paying more for consultations.

You should actively start wanting to pay more for consultations than you already do because the higher the consultation fees surgeons are able to make the less likely they are to drag you or your employee through surgery.

For example on coral during the year of 2023 we had a provider bill X amount for the year. Due to the fact that surgeons are payed more on coral for consultations they may have preformed less surgeries during 2023 but they may have made even more money because people had a fair option to go to where the number one incentive wont always just be to rush you to surgery. 

 

By paying them more for a consultation you are removing the incentive for a surgeon to spend time in surgery if they are not required to do so, which in turn reduces the your own surgical spend.  Its really a win win type of situation that would greatly benefit both parties.

 

Yes you are basically asked to pay more up front before the surgery but you are also paying more while reducing the overall chance of needing surgery so at the end of the day even if your paying more up front your saving much more money on surgical spend in the long run.

 

Think just how many surgeries you could avoid if your surgeon wasn’t incentivized to actually perform surgery on you. Other positive outcomes that may result from you paying a higher consultation fee could be : 

  1. It helps separate genuinely interested patients from time wasters. If a person is serious about having a treatment, they will be prepared to pay for expert advice (Glowday, 2022).

  2. It helps to distinguish and seperate between the actually good surgeons and the not so good ones. (Glowday, 2022).

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

Lower Consultation Fees Leads to More Surgeries

     Using the previous study, we can also ascertain without any surprises that lower consultation fees will keep the status quo going which is “Fee for Service.” In the US a total of 51.4 million surgeries were performed in 2023. That is a staggeringly high amount that we can aim to keep down by raising the fees of consultations.

 

If consultations fees are always kept low, then there is a higher incentive for surgeons to stay in surgery longer because they get paid more and, therefore surgeons are incentivized to operate on more patients. They may opt to always go into surgery instead of pushing for a non-surgical treatment method, which in turn harms the patient more than anyone else.

 

Surgery is always incredibly stressful for the human body, however, if the surgeon that performs this surgery is always incentivized to perform it then they will increase their surgery rate instead of lowering it to get paid more.

 

This also harms the patient because instead of paying for a treatment method that does not require surgery, they will be pushed towards the more expensive treatment option that requires the use of surgery.

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(Aydoğan, 2023)

Higher Consultation Fees Leads to Less Surgeries

Given the information stated by Clemens & Gottlieb, 2014 a possible incentive for surgeons should be consultation fees. If they can generate more revenue based on a higher valuation of their consultation fees, surgeons will pay more attention during consultation’s and would be more eager to perform them more efficiently and effectively.

 

This may in turn also lower surgical rates, due to the fact that a good consultation may reduce the need for surgery as it may present more non-surgical options. For example, here at Coral, surgeons are given a higher consultation fee compared to the normal hospital system.

 

Besides the obvious self-promotion here this does offer surgeons the chance to perform these consultation more often and invest an even larger portion of their time doing these consultations. By allowing these surgeons to get paid more during these consultations we are in a way reducing the surgical spending of your business by facilitating a new avenue in which your employees could potentially avoid surgery altogether.

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(Surgical procedures market , 2024)

How much you are currently paying for consultations on average

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 anywhere from around 31$ to 184$.

 

Why would one patient go to a Surgeon 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, we on average should pay surgeons more for these consultations

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Conclusion

To conclude, it is evident that there is a direct correlation between

Consultation Rates and Surgical Spend. The current method of “Fee for Service” is not helping and is in fact causing the actual quality of service to diminish, while surgeons are heavily incentivized to perform more surgeries, they will be more inclined to always push towards the surgical option more than a non-surgical option. Who would have thought that right?

This does makes sense though because based on their current compensation structure if they push towards a non-surgical option they will be making significantly less wages than normal which puts them in a tricky position and also puts the patient in a horrible position financially, instead of saving money by going through a non-surgical route they will always be pressured by their surgeon to choose the more expensive surgical option.

By raising consultation fees and tearing down the status quo of the normal hospital system, surgeon’s incentives will continue to change and skew towards a more patient friendly environment. This will help patients save lots of money by lowering their medical health spending.

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