Cash Pay Surgical Centers and My Knee Surgery

About four years ago I took this picture with Keith Smith MD when he came to Charlottesville, Virginia.  It is about an hour and a half from my house but there was a new cash pay facility called the Monticello Community Surgical Center opening up there.  I listened to the talk by Keith and the FMMA (Free Market Medical Association) and was impressed.  Fast forward to Thursday where I decided to have my knee scoped at this same center. But why did I do this?

In November of 2016, at the age of 51, I had to have a total knee replacement.  A college wrestling injury led to 4 arthroscopic surgeries and 2 ACL repairs but the joint had finally given out.  I had my TKR here in Lynchburg and it was a brutal recovery.  The three months following the surgery consisted of no sleep and intense pain. Sixteen months later and I am having tremendous pain again with very loud crepitus with this same knee.  I thought I had something called Patellar Clunk Syndrome, which meant more surgery.  Here is the interesting part.  The local and ONLY health insurance option (Piedmont) offered a plan for $1800 a month for my wife and daughter and myself.  This was ridiculous so I went with Liberty Health Share for $480 a month.  The problem is that they were not going to cover the knee for a few years as it is a pre-existing condition (you get more coverage on these conditions each year with the plan) so I needed a cash price.

I called the local orthopedist who did my surgery and personally asked if he would get me that price.  He said he would get back to me.  A week later and nothing.  After badgering them some more his staff finally gave us “his” price but we would have to find the anesthesiologist’s price and the facility price on our own.  You have got to love this type of customer service technique.  And I am a colleague!  Add to this that they (the orthopedist, the anesthesiologist and the surgical suite) are ALL housed in the same place yet I would have to do all the work in getting a quote.  That’s when I thought about Keith Smith again and went back to C’ville where the facility was cash pay transparent just like his in Oklahoma.  For $3740 I had the consult and full surgery done.  It was that simple.   For those that want to know, I had severe arthrofibrosis in the TKR.  There was supposedly five times more scarring than the orthopedist, who did the surgery, had ever seen before.  It was even growing into the TKR prosthesis itself (if anyone has any idea why this happened please tell me even if it was due to the last ortho’s work. I really need to know).

Right now I am sore and at home recovering.  I am happy with my decision to go to the cash pay facility.  When you think about it, the cost of using regular insurance probably would have been more than $3740 and with a $6K deductible, I would have hit that easily.  The system is so screwed up.  What other business are you UNABLE to get a cash price for something?  The local orthopedic facility never got back to me and the orthopedist doesn’t even know that I had more surgery.  I am embarrassed that professional courtesy rarely exists anymore.  Imagine how patients, who are not doctors, feel?  We can do better.  We need to do better.

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