In the US, Medicare provides federal insurance for people over 65, as well as younger people with disabilities and people with end-stage kidney disease. Altogether, the program costs about $600 billion and is second only to the military in government spending. Around one-fourth of all Americans benefit from this program, but research indicates that the care they receive through this program may not always be the best option for them - or the wisest use of taxpayer dollars.
Researchers at Johns Hopkins Medicine recently reviewed data from over 200,000 Medicare patients and found that a better option often existed for patients who underwent one of seven common surgeries. Read on to find out if you need to ask a few more questions before agreeing to a major surgery.
For this study, published in Surgical Endoscopy, the researchers looked at seven surgical procedures: cholecystectomy (gallbladder removal), bariatric surgery, colectomy, hysterectomy, inguinal hernia, thoracic, and ventral hernia. Many of these surgeries, while common, can cause complications in older adults. And these complications are both costly and dangerous. However, surgeons also have options for minimally invasive surgery that can drastically reduce these complications, mortality, and overall costs associated with the procedures.
Of the 233,984 patients the researchers reviewed, 102,729 had standard surgeries, and 131,255 had minimally invasive surgery procedures. For five of the seven procedures, the minimally invasive surgery patients had lower complication rates. All but the inguinal hernia patients had lower hospital readmission rates after minimally invasive surgery, and for six of the procedures, minimally invasive surgery was linked to shorter hospital stays. For four of the procedures, Medicare costs were lower with minimally invasive surgery.
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The choice seems obvious. While not every patient is a candidate for minimally invasive surgery overall, the rate at which these procedures were used in the Medicare patients was lower than among the general population. While it can be hard to identify which patients were candidates for minimally invasive surgery, the differences in overall rates is telling. It seems that some doctors may be opting for high-cost procedures unnecessarily, even when research suggests that lower cost procedures would be better for both the patient and the system.
Whether you’re a Medicare patient or not, you need to be an advocate for your own health. But Medicare patients may need to be even more vocal. Don’t just accept the surgeon’s recommendation of an invasive procedure. If he or she insists that it’s the best option, make sure you’ve discussed a minimally invasive surgery option and understand why it’s not the right choice for you. In general, you want to opt for the least invasive option that will solve your problem effectively.
One final note: If you do have an invasive surgery coming up, I strongly recommend that you prepare for it with my preconditioning protocol, if possible. This should drastically improve your recovery time and your likelihood of experiencing complications. You can find more information about this on my website.
Yours for better health,
Frank Shallenberger, MD