Dr. Lonner

[Back-out]

Jess, I think you missed my point about the need for triage. What good is it, if a doctor continues to be there - for the highest bidder? I prefer a surgeon who sets a standard of condition (not finances), especially if it's where he feels he can do the most good.

What good is to me if Dr. Boachie accepts everyone who can self pay a 150K surgery (only the surgeon's fee!) - which happens to satisfy the dual purpose of enriching him and reducing his patient load to where he wants it? I respect Dr. Lenke more. He could charge what the market will bear like Boachie to reduce his unmanageable load, and chooses not to.


And by the same token, what good is it to me (or most sufferers) to be nominally "accepted" into his practice only to have to wait five or more years? Those of us with rapidly progressing curves would already be untreatable - or dead - by the time he got to us!

[jrnyc]

as far as i know, Dr Boachie takes "assignment," so if one has insurance, he will accept what the insurance pays...i was just unlucky in that i have to go in network...so i couldnt have him as my surgeon...but then it worked out better for me because i like Dr Lonner better, always have, and not only does he take my insurance, but he now will do minimal invasive on me...havent heard of Boachie doing that..

i never said Dr Lenke should operate on everyone...just that it shouldnt require a 100+ curve to get his attention...and as far as i have heard, once a patient waits for the opening to be seen for consult, they are in for surgery...the consult wait is not 5 years, but 10 months or so...

i have never cared for "exclusive" doctors...exclusive in any way...in terms of finance or condition!

Dr Lenke can do whatever he wants...again, i dont have to be impressed by it...i am far more impressed with doctors in the field, working for the good of all those suffering...there is no such thing as someone with a 60 or 70 degree curve not suffering enough!

jess

[Doodles]

Jess--
Personally, I'm glad there are doctors who specialize in the most difficult cases. When others can't or won't do it or don't have the confidence to do it, I'm glad there are the Dr. Lenke's. Another perspective--I had meant to post this anyway. When I went for my check-up in April, my sister-in-law gave me a copy of the SL Post-Dispatch. Had a big article about doctors in SL doing pro bono work for foreign children--more than anywhere in US. Dr. Lenke was one of the main featured doctors. Here are a couple paragraphs:
Dr. Lawrence Lenke performs surgery for no pay on an international child about every two to three months. "That's why I became a doctor," he said.
Lenke said it was getting harder to persuade hospitals to accept chairty cases. His waiting list which can reach up to 12 months, includes seven children without ability to pay.
"I want to help more of these kids, but we are limited in the financial real," he said.
Even if doctors donate their services, hospitals have to pay for the nursing and support staff, etc. etc. etc.

It features a 14 year old who has had scoliosis surgery from Lenke and how they live with a host family. It talks about other surgeons also. The article is from 4/11/10. You could probably Google it. Janet

[jrnyc]

i'd like to know how people would feel if they needed heart surgery but the surgeon said they werent sick enough...?

i am so grateful the the surgeons like Dr Boachie and Dr Lonner who operate on SEVERE curves of over 90 degrees but still see the little people like me...i do not wish to wait til i reach the 90 degree mark on my lumbar curve...which i am sure i will get to if i do nothing...to see the great Dr Lenke...

i'd hate to hear a cancer surgeon tell a patient that their tumor isnt big enough yet....

but that's just my opinion

jess

[loves to skate]

Dr. Lenke is about to assume presidency of the NSF as of Sept of this year.

Are you sure about this? Joseph O'Brien is president of the NSF and as far as I know, he is not a doctor. Could it possibly be the presidency of the SRS?
Just wondering.
Sally

[Back-out]

Are you sure about this? Joseph O'Brien is president of the NSF and as far as I know, he is not a doctor. Could it possibly be the presidency of the SRS?
Just wondering.
Sally

Quite right! I meant the medical foundation. I am only now realizing the difference!

[Back-out]

Jess, Dr. Boachie wouldn't see me because my insurance wasn't good enough, In fact, I spoke more than once to their special insurance rep who said some hurtful things about my insurance plan - the best I can purchase in PA as a private individual (and not cheap). Others apologized for her but she is obviously senior to them.

You may have found if you investigated it, that "takes assignment" means only that he accepts what your company will pay and then counter bills you for the remainder.

That is likely to mean you find yourself with an out of pocket cost of 150K (what I was told to expect). And aside from the hospital, there is the little discussed issue of the anesthesiologist's fees - very high naturally for this very lengthy operation. These too are not covered by many/most plans and the patient can be left paying most of them too (av. $11K also per same patient rep).

He officially accepts no insurance but will condescend to accept the out of network benefit ones insurance pays PLUS the "balance billing" , As for MEDICARE - that's beyond the pale!

His privilege, of course! And as I said, he needs to thin out his patient demand, He could never take everyone who wants him as their surgeon. So he charges what the market will bear. So do many/most of the HSS surgeons.

They wouldn't even let me see him for a consult - for information - regardless of whether I paid out of pocket ($450+ "depending on complexity"), I was told he had changed his policy. He doesn't want to "waste his time" seeing someone who already knows in advance they could not afford to go through with surgery, using him as their surgeon.

[jrnyc]

i posted this note and somehow it disappeared...

wellll...now i understand what would take up his time and require him to reduce his caseload......cause i didnt think the Foundation would be that time intensive and couldnt understand why a surgeon would be in charge when it is currently someone without an MD.....

i still thank goodnes for doctors like Dr Boachie and Dr Lonner...who operate on large and larger curves...

jess

[jrnyc]

as far as i know and all the surgeons i've experienced, "takes assignment" means the patient wont owe once the insurance pays whatever it pays...so obviously, he is not taking assignment if he is billing for the rest in cash...there are a few patients on forum who had surgery with Dr Boachie...would be curious to know what they had to deal with concerning insurance, but it is their right not to reveal it here...

jess

[rohrer01]

Jess, Dr. Boachie wouldn't see me because my insurance wasn't good enough, In fact, I spoke more than once to their special insurance rep who said some hurtful things about my insurance plan - the best I can purchase in PA as a private individual (and not cheap). Others apologized for her but she is obviously senior to them.

You may have found if you investigated it, that "takes assignment" means only that he accepts what your company will pay and then counter bills you for the remainder.

That is likely to mean you find yourself with an out of pocket cost of 150K (what I was told to expect). And aside from the hospital, there is the little discussed issue of the anesthesiologist's fees - very high naturally for this very lengthy operation. These too are not covered by many/most plans and the patient can be left paying most of them too (av. $11K also per same patient rep).

He officially accepts no insurance but will condescend to accept the out of network benefit ones insurance pays PLUS the "balance billing" , As for MEDICARE - that's beyond the pale!

His privilege, of course! And as I said, he needs to thin out his patient demand, He could never take everyone who wants him as their surgeon. So he charges what the market will bear. So do many/most of the HSS surgeons.

They wouldn't even let me see him for a consult - for information - regardless of whether I paid out of pocket ($450+ "depending on complexity"), I was told he had changed his policy. He doesn't want to "waste his time" seeing someone who already knows in advance they could not afford to go through with surgery, using him as their surgeon.

Are you sure you are talking about Boachie? I just went to his website and he even has a plan for people that can't afford to pay? I'm confused???

[Back-out]

Jess, Dr Lenke used to take all comers (as long as their condition warranted surgery and they qualified - many criteria). He probably will again, though I suspect it won't until his patient load drops to reasonable time frame.

I think there must be a basic contradiction in a responsible surgeon's mind between wanting to offer the best care s/he* can, and knowing full well that making someone wait while his/her curve is deteriorating, is risky. There IS a strong time constraint involved.

Sorry, about mix-up about which Foundation was being referred to! FWIW Boachie is another past president.

*I write s/he here out of habit, though I'm sadly aware there don't appear to be ANY female deformity surgeons. Maybe it requires too much upper body strength...

BTW when I have disagreed with you (insurance, etc) it is entirely based on what I've been told by a given surgeon's staff and sometimes by the surgeon HIM(oh, well) self

[jrnyc]

Hi Amanda
the issue of "taking assignment" is an important one...because the phrase means that the doctor will indeed take the money the insurance company pays...usually to the patient...so the patient either cashes the check and pays the doctor what the insurance company paid them or the insurance company makes the check out to the doctor...it does NOT mean that they take the insurance money and bill you the rest.....that is NOT taking assignment...that is charging the patient!!

i dont take it personally when anyone on forum disagrees with my opinion...i just consider it their point of view...
and alot of the time, unless you ask the doctor directly (at which point, i've seen some of them blush with embarrassment, cause they often dont want to know the details) you can get a different answer from each staff member in a doctor's office! but things change...i know doctors who have changed which insurance companies they accept from year to year...

jess

[Back-out]

rohrer:

Are you sure you are talking about Boachie? I just went to his website and he even has a plan for people that can't afford to pay? I'm confused???

I'll check out the website but I can't TELL you both how much I've spoken to both his office rep (who also handles Cunningham) and the HSS insurance rep for both of them who was very adamant, especially about my insurance plan which she referred to as "charity".*

SHE is is the person who told me all this, and generally such persons act as authorized gate-keeper for a given doc. Maybe she is over-stepping her authority, though, and he would be horrified at the things she's saying in his name,

I wonder who I should call to step over her and double check his approach to reimbursement. It's a certainty, though, that he doesn't accept MEDICARE and as for the rest, it's worth checking. I've already been told by several other phone people, that some of the quotes I came up with from the insurance rep were deemed rude and "out of line".

The truth is probably somewhere in the middle.

As for "working with people who have problems paying", my experience is that what that means, is they'll work out a payment plan to stretch over time, usually with an interest rate attached. In fact, there are companies specializing in medical and dental debt, there to take over the arrangements. Then the doctor's office doesn't have to get into the collections business if the pt doesn't come through.

If it's the same plan I suspect it is, it's the one to which HSS itself subscribes for needy (un or under-insured) patients. I've long wondered about it. I picked up their- form to apply. I've gotten the feeling that it's the payment play version of meeting needs. Paying over time wouldn't be an improvement for me, as my finances are due to decline rather than improve (or even stay stable) But I will check it out!

To me, meeting needs, is that a significant write off is involved, if the pt meets a means test (and after their insurance kicks in whatever it does).

Mine, for as long as I have had it, has been pretty good with out of state, charges, even though their calculation of U & C (usual and customary) is always somewhat under the real figure for a given zip code. To digress here (and complain), it is maddening to have the final figure come as a surprise! However, no one seems able to give me an accurate figure in advance, for these out of state charges. It's one thing for a pack of gum, or even a single consult, but quite another for such a HUGE ticket item!

Perhaps, I'd be well advised to hire an insurance advocate to arrange things for me paid, on an hourly basis rather than a percentage. Usually they come in to play after the bills are issued, but I want someone to get me a straight answer beforehand. OTOH I don't HAVE to work with Boachie! However, I do think he should be made aware of how his policies are represented to people. As one of the other reps said, "she makes us all look bad".
***************************************

[Back-out]

re whether I'm a "Charity case" (grrr)

*Nb I don't know where she got this as I saw a knee surgeon there too, and he billed Blue Cross $800+ for his visit including a cortisone injection (listed as "surgery!") . After some write-off, he was reimbursed almost $700 including $100 which I'm to pay. That's OK with me, in line with expectations. Hardly charity! Maybe there's a group plan under Capital BC which is tight-fisted and she got us mixed up, but whatever the case:

a) I am only quoting
b) she was rude no matter what
c) I suspect she was representing physician feedback, somewhat distorted For instance, she made it clear she had had to take complaints if she accepted a patient's coverage, and it proved inadequate. The anesthesiologists had complained (bitterly) at their pay back.

She sounded somewhat confused (in facts - NOT attitude!) OTOH it IS complicated, since going out of state means bills have to go through two Blue Cross plans. They translate my coverage into what the U and C prices are in their zip-code. I'll bet there's some randomness involved.

[jrnyc]

Amanda
why dont you go to a doctor that takes your insurance...i just call the doctor's office and check...if they dont take mine, i'll either ask for a consult and tell them i'll pay out of pocket, or find another doctor...simple...

i dont expect that all doctors will take my insurance...just as i know for a fact that there are lots of doctors who dont take Medicare...that is just the way it is....not fair, maybe, but reality...

jess