Do podiatrists really want bunion sufferers to non-surgical bunion treatments?
Not too long ago there was plenty of press about the battle between Aetna and a number of podiatrists in California. Doctors were allegedly cashing in on the bunion surgery billings, some to the tune of $66,100 per patient, for procedures that normally range from $3,000-$4,000. These clinics were even referred to as “cash cows” by one Georgetown University expert, “[these providers] only make money when they do stuff”.
As best stated best by the LA Times [L1]“How does this affect you, the patient? Many health plans allow patients to get treatment from out-of-network providers, on the understanding that the choice will cost them – they’ll pay a coinsurance share of 20% to 50% of the bill, and the insurer will pay only a percentage of the remaining “usual and customary” fee for the service, supposedly an average of the fees charged. The idea is to encourage patients to use network providers who accept negotiated fees, which saves everyone money. The Aetna and United lawsuits say the BASM clinics winked at the patient obligations by waiving the coinsurance charge and promising not to bill patients for any balance not covered by their insurers. They then allegedly filed sky-high claims with the insurers, hoping to be reimbursed for the whole sum.”
What are Podiatric Sugerons?
The question is even more relevant in the UK where there is a new breed of health care practitioners called podiatric surgeons[L2]. These surgeons use local anesthetic instead of general, which allows the procedure to take place in an clinic’s office. What is the per-requisite to become a podiatric surgeon? Only 1 Year post graduate course in surgery after a chiropody or podiatry degree. That’s it! These practitioners were told in 2010 by the UK’s Department of Health not to use the title “podiatric surgeon” after a rash of complaints were filed. The world of podiatric surgeons is much less monitored and regulated. Also, the span of common practice varies from those that work closely alongside orthopedic surgeons and those who act on their own. Patients are referred for NHS treatment and are not aware of their qualifications or skill level. Some patients report suffering from all sorts of terrible and eventual outcomes including broken bones, nerve damage, gangrene, and toe amputation. According to an article in the Daily Mail one woman reported severe nerve damage for 3 years following her surgery. She was finally able to get orthopedic surgery in attempt to correct the prior surgery but still suffers from excruciating arthritic pain and often has more pain then before her bunion surgery. Also mentioned in the article by Daily Mail, Huw Foxall, a 67 year old runner from Ealing, West London, suffered severe gangrene which went unnoticed because his foot was put in a plaster boot following an operation by a podiatric surgeon to correct hammer toes. He had to have his big toe amputated. “The cast was taken off and the foot was a truly awful sight, it was black and blue,” he said. Yet another man had to be financially compensated after the unnecessary surgery left him unable to work, thereby ruining his career.
So the question is asked again, do podiatrists really have your best interest in mind when it comes to deciding what the best bunion treatment is? What if the easy and convenient solution is a non-surgical bunion treatment like Bunion Bootie, will they reject that for the expensive surgery? Certainly we hope that these examples are the exception to the rule, and not something to be worried about in the US, but it still begs the question if podiatrists should be considered the subject matter expert when it comes to the bone structure and alignment that is often compromised with moderate or extreme bunions.