The value of an ongoing relationship with your surgeon's office

[ColoradoTJS 9]

Starting this topic because I'm weighing two opposing courses of action...

I have been a "self pay" patient, and paid more than $17,000 so far for my surgery to my bariatric surgeon's practice, plus the anesthesiologist, the blood work, etc etc etc. Have been happy with the results (48 pounds down and feeling great).

But, they've started charging me for follow-up visits now. Got an $85 bill for a follow-up visit to a physician's assistant last week that held little to no value for me. I feel like they are just stringing me along at this point. I could be getting the same attention from my primary care physician at this point, and these visits could be more integrated into my overall health.

I am thinking that I'm about done with my surgeon's office. They want me to go get a whole battery of blood tests done (that will probably cost me another $500+) and I'm just not going to do it. My PCP can direct me to do those, if necessary.

What are your thoughts? At what point should we say HEY THANKS SO MUCH, but I'm done being a cash source for the surgeon's practice?

Thanks.

[McButterpants 2,846]

I was self pay and went out of my area for surgery - I selected a local bariatric surgeon who took me on as a patient even though she didn't perform the surgery. I pay $120 for my visits with her. For me, it was important to have aftercare and follow up visits with her. I wanted to have a local resource where I can go to make sure what I'm feeling is normal and she can look at my bloodwork and determine if anything is wrong.

I get the blookwork requirements from the surgeons office, then have my primary care doctor order the bloodwork so my insurance will pay (they have to code it as anything other than weight loss for the insurance to cover). I then take my results to the surgeon. That has saved me about $1400 this year.

In the end, as with everything else with this journey, you need to do what's best for you. I feel like I get a value from my surgeon's visits and I really like what she offers.

[VSGAnn2014 12,992]

You're the customer / consumer / patient. You should get value for your dollar.

Find and negotiate the best price you can for the benefits you obtain.

BTW, if you have insurance, your insurance may pay for some of the blood panel work you need done.

And yes, I think you should have those blood panels done after WLS.

The point of having this surgery was not just to become "skinny," but to become healthy. You need to find out if you are.

Best o you.

[*Lexie* 1,486]

My insurance covered the surgery but I have been surprised that they have not billed my insurance for any of my follow up care. Maybe that varies by practice but it should be included in the price because if you don't go back, they can't track their weight loss success rate. There's a benefit to them for you to return. I'm with you, I don't get a lot out of my follow up visits. My office does offer advanced skills classes (for free) and I am taking advantage of those and attending. Helps with emotional eating and such. I need all the help I can get.

[bikrchk 1,313]

The practice I had my surgery done with kind of "fell apart" when the long time nurse coordinator left at the same time as the primary (my) surgeon. This all happened right about the time I was due for my 1 year blood work. Love and miss them both and got great care there! My insurance has a lifetime cap on bariatric care that includes follow up, and I reached it about 6 months in so I'm basically self pay and have no relationship with my surgeon's office anymore. My 6 month labs were perfect.

I DO think it's important to do our yearly labs. We've altered they way our bodies absorb nutrients and should be checking in proactively to ensure we don't have problems brewing. There are some deficiencies, (Calcium for one) that may have no symptoms now, but come back to haunt us years later by which time there's nothing we can do about it. I am successfully maintaining and I am compliant with supplements, so I decided to wait and follow up with my PCP, (I do a yearly physical with blood work there anyway). If I need to add a few extra blood tests to the normal battery to check for the typical bariatric deficiencies, so be it. At least the bulk of what I do under a yearly physical will fall under "preventative care" and be covered at 100%. I've had too many WLS friends who caught things (usually low Iron or B12) in their scheduled labs that may have gone untreated otherwise to leave it to chance.

No more support groups either. I get a lot out of face to face support and thankfully, most of the other hospitals have open groups so I attend one of those on a monthly basis.

Edited February 23, 2015 by bikrchk