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Author Topic: To Wait or Not to Wait, That is the Question  (Read 1497 times)

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JulieB

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To Wait or Not to Wait, That is the Question
« on: December 01, 2010, 12:11:05 PM »
I have read of the importance of having an experienced doctor perform hip resurfacing.  My dilemma is that my insurance will pay my PA doctor, who has done less than 100 hip resurfacings, to do my surgery, but will not pay my MD doctor, who has done more than 2000 hip resurfacings.  I should have the surgery soon in order to recuperate before a summer of working at camp.  My activities, movement are fairly to significantly hindered.  Do I continue to wait (I was hoping to have this surgery last year) in hopes that I will acquire different insurance or go ahead and have the surgery with the PA doctor.

jerry3839

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Re: To Wait or Not to Wait, That is the Question
« Reply #1 on: December 01, 2010, 03:25:27 PM »
I will have surgery on dec 15 with a doctor that has done less then a hundred becouse my insurance does not cover the doctors out of my are butt I'm in to much pain to wait and I have no money to pay for the surgery I think if the surgery is going to be a success it does not mater how many surgeries the doctor has done just like other surgeries theirs a risk and can't nobody take does risks out of surgery the only person to decide wether it is good or bad is the great lord and that's the most experienced person their is good luck I'm only 29 and getting a new hip to much pain

Pat Walter

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Re: To Wait or Not to Wait, That is the Question
« Reply #2 on: December 01, 2010, 04:13:21 PM »
Hi Julie

In my opinion experince is very important, but I have read thousands of stories for almost 6 years and followed all the medical studies and National Registries.  WHen I say expeince, I mean a thousand or more.  The large amount of negative press about resurfacing has been based on poor outcomes of resurfacing by inexperinced surgeons.  The odds are not bad if you use a less expiernced surgeon - about a 4% revision rate - but why gamble if you don't have to.  In your case, you might not have a choice.  I will hope you are not one of the 4 out of 100 that has problems.  That is not bad odds. 

I only continue to suggest using the most expeirnced surgeons - when possible, because there is a better retention rate.  Before the BHR was approved in the US in 2006, the retention rate by the expeirnced surgeons overseas was 99.8 %    When the US doctors started resurfacing, it dropped to 96% worldwide.  http://www.surfacehippy.info/bhrhistory.php

The problem with waiting is that your hip could deteriorate too much for a resurfacing.  You really need some input from the top surgeons to know exactly where you stand.  Pain is not the only indicator of a deteriorating hip.  Only an x-ray read by an expeirnced surgeon can tell you how your hip is. 

Have either of you tried to appeal your insurance decisions?  Sometimes that can be done.  What additional amount would it cost to use one of the top surgeons? You are very young and sometimes the cost of paying for your health treatment is worth it.  I was 61 when I had my resurfacing and did not want a THR since I was very active.  I had no insurance.  I flew to Belgium to have Dr. De Smet do my resurfacing and the cost was $18,000   I am still paying off my credit cards, but would not have it any other way.  My health was a very good investment.

Whatever either of you decide - please keep in touch and let us know how you are doing.

Pat
Webmaster/Owner of Surface Hippy
3/15/06 LBHR De Smet

23109VC

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Re: To Wait or Not to Wait, That is the Question
« Reply #3 on: December 02, 2010, 12:25:54 PM »
i waited to do my surgeyr... not because of $, but because I was nervous about the procedure, and initially,, the pain (while a nuisance) was tolerable...  I'm at the point where it's not something I want to deal with anymore...

My HMO sent me to a doctor w/in the network who lacked major experience.  I opted to switch insurance plans when my employer had the "open enrollment" period...  I have probably delayed getting surgerya bout 6 months by doing this...but I figured I"ve put up with the pain for a decade..what's six morem onths to go to the doc I want.

granted, I will pay out of pocket b/c I am going to a PPO / doctor of my choice - but in the end, I figured paying a few grand out of pocket will be worth it if I get a good result... if you truly cannot afford even the costs of a copay if you were to go to a PPO / pay for it - then just get it done with who your HMO gives you. 

if you don't like who they sent you to - try this..  find a doctor who IS in their network who has MORE experience, who you woudl prefer, and then petition the HMO to send you to that doctor.  if the doc is within network, costs may be very similar.  don't give up when the first person says no.. apppeal it...  the HMO's only care about costs..so if you canf ind a doc that is in their network, who can do it for the same cost, push and push to get that doctor...

good luck.

in the end..if you are in enough pain...any doctor who can "fix you" will be better than the pain you now have.. good luck
Sean
Dr. Gross- Biomet uncemented, 2/23/11

hipnhop

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Re: To Wait or Not to Wait, That is the Question
« Reply #4 on: December 16, 2010, 02:27:00 PM »
My situation is almost the same. I will be my Ortho Surgeons first HR. She just got trained by Dr. Su. I am so nervous.I am trying to get a skilled HR surgeon in OR with me. I was just informed that SMith-Nephew Technicans will be in the OR too.  I am really going through it.

 
3/2011 and 2/2012 HR Dr. Craig Thomas

Pat Walter

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Re: To Wait or Not to Wait, That is the Question
« Reply #5 on: December 16, 2010, 04:41:32 PM »
23109VC

I think you made a good decision to take your health decision in your own hands and be willing to pay for part of it.  I did the same in 2006 and paid the full amount of my resurfacing with Dr. De Smet that cost me $18,000    I put it on my credit cards and felt it was the best financial decision I made in my life - it was to get my life back without pain.  I was an older female and wanted a really expeirnced surgeon doing my surgery.

You won't regret paying a few thousand to get what you want - you will be active and out of pain.

Pat
Webmaster/Owner of Surface Hippy
3/15/06 LBHR De Smet

 

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