The ColoHealth Health Wealth Newsletter
September 2019
Vol. 9, Issue 9

Crazy Costs & Pointless Procedures: How
to Tell If You Actually Need that Doctor-
Recommended Surgery

Doctors have been pretty well-respected in our country for a long time, and for good reason. With all that schooling and know-how, most of us are just fine with letting them make decisions about our health care. Whether it is a medication prescription or a surgery recommendation, most people are in the habit of taking their advice without a second thought.

Yes, doctors are the ones with the fancy medical degrees. But the truth is, these recommended procedures might not always be necessary. In fact, a 2017 survey asked more than 2,000 physicians in the United States what percentage of medical procedures within their profession provided was actually necessary.

Their answer? 11 percent. It’s not a number that instills the greatest confidence in doctor recommendations, does it?

The Doc Says: “You Need Surgery” – How to Tell if You Actually Do

Now, there is a whole host of medical procedures that are absolutely necessary. These include the surgeries that need to be performed immediately when the problem is identified, such as taking out a dangerous appendix or getting fixed up after a bad accident.

The problem is when there is less certainty that the procedure being recommended is actually needed. Take back pain for instance. While your doctor might have a procedure in mind to fix everything right up, another doctor might recommend something completely different. That is simply due to the fact that back pain is not an easy thing to nail down.

Agreeing to a procedure just because “your doctor says so” is not always the best option. Informing yourself aboutboth the procedure and the doctor that is offering it is the only way to ensure that you’re getting the most valuable care.

Be Informed, Not Bossed Around, About Your Health Care

“Following the doctor’s orders” has been a valuable axiom for hundreds of years, but there are certain situations in which their orders might not be the best thing for you.

The first thing you want to do is ask a lot of questions. Find out as much as you can about the proposed procedure, and be sure to keep all the notes. You can use these notes, as well as copies of all your records, as valuable resources in the information gathering process.

Always Get a Second Opinion

Even simple and reasonable-sounding surgeries have a small yet significant chance of being unnecessary. Getting a second opinion helps you understand what the real consensus on the matter is, regardless of how much you trust your doctor.

Don’t be worried about what your primary physician is going to think. Getting a second opinion is not going to hurt their feelings. In fact, most good surgeons will recommend it themselves, and if they don’t, it might be time to change things up.

Talk to Surgeons That Aren’t in Your Area

Some studies have shown that the types and costs of procedures will be similar within limited regional areas, so seeking a second opinion from a surgeon outside that area is an effective way to see how other people are handling it.

Because many doctors and surgeons will offer consultations over the phone or web, you might not even have to drive anywhere.

However, keep in mind that your healthcare network might limit your choice of doctors. If this is the case you need to make sure that the surgeon you choose is within your network.

Don’t be Afraid to Talk About Pricing

Sometimes, a high deductible or a non-covered procedure will be limiting factors in what kind of care you can get. It is always best practice to have clear conversations with your provider about the specific pricing structures for the procedure in question.

Have Questions About Finding the Right Doctor?

While many healthcare plans have restrictions that tell you who you can and can’t see for care, other options are available. Some healthcare sharing programs will actually allow you to see any doctor you like, which really opens your options up when it comes to a potential surgery.

If you have questions about how your plan compares to some of these programs, just contact your Personal Benefits Manager.

To your health and wealth,

Wiley P. Long, III
President – Colohealth

The Colohealth Health & Wealth Newsletter is published monthly and emailed to subscribers at no charge. Subscribe now to stay on top of the critical information you need to know about health insurance, healthshare plans and managing your finances to achieve financial security.