Re: some very basic facts

[Guest guest]

Thank you Jessie. We needed to hear that. Truely.

Myshalla

> : The reason American surgeons don't see foreign surgeons

band

> patients has nothing to do with politics. It has to do with money

and

> liability. That kind of waiver that you are offering to sign

would not be

> legal. You or your heirs could still hold the surgeon and the

hospital

> responsible. Surgeons are willing to take on that responsibility

for the

> full price of a band ($7,500) and when they have total control

over the

> surgery. They aren't willing to take that chance for the price of

a fill

> ($150). Our malpractice insurance is over a half million dollars

a year.

> You can't break even on just doing follow-up.

>

> You can cry " BS " all you want but you are failing to understand

some very

> basic facts about medical practice in the USA.

>

> The bottom line is that you could not afford American medical care

at the

> going price and you chose a cheaper alternative and you get less

service for

> that price. When I buy shoes at K-Mart I don't expect to be able

to take

> them back to Nordstrom nor do I expect the same level of product

and service

> at Mac's as I might get at a fine dining establishment.

>

> There are American surgeons who will see you. Dr. Fox and his

partners in

> Tacoma have always been willing to see patients banded elsewhere.

Any

> emergency room will see you when you are truly having an

emergency. It is

> illegal and unethical to deny care to people in an emergency. By

going out

> of the country you (and I) limited our options for follow-up. I

don't feel

> bad about that. I knew all this BEFORE I went and I accepted the

risks and

> the hassle. I have a yearly fluoroscopy in Tijuana every year to

check my

> band. That's my responsibility and I accept that.

>

> If I have slippage or erosion and need my band replaced it's quite

likely I

> would go back to Dr. Rumbaut in Monterrey -- because I still can't

afford to

> cash pay American hospital prices voluntarily. In an emergency I

might not

> have a choice and I know that. But most band problems are not

emergencies.

> I know the warning signs and I am cocky and stupid enough to think

I could

> get myself to Monterrey on time.

>

> Even though I work for weight loss surgeons and I would trust

either of them

> to operate on me at any time -- my insurance doesn't cover gastric

band

> problems and even if they waived the surgical fee for me I would

probably be

> unable to pay the cost of a couple days of hospitalization, an

> anesthesiologist and a surgery fee let alone any time in the ICU.

American

> medical care is VERY EXPENSIVE. That's not entirely the surgeon's

fault and

> I think you are very wrong to blame all the problems with the

American

> medical system on doctors.

>

> We need a total overhaul of the medical care system in this

country. I'd

> like to NUKE the whole system of care we have now (or non-system of

> non-care) and start over from scratch myself -- but then I've been

a nurse

> for 24 years (plus 5 years as a lab tech before that) and I know

way too

> much about the way things don't work.

[Guest guest]

wrote in part,

American

medical care is VERY EXPENSIVE. That's not entirely the surgeon's fault and

I think you are very wrong to blame all the problems with the American

medical system on doctors.

I have enclosed some correspondence from Don Mills at Inamed about their

attitude towards patient aftercare. Hope I'm not being a butt-in. I just

thought it might give some additional perspective.

Hello Bill,

As you would suppose we are well aware of the follow-up issues for patients

banded outside of the US. A couple of comments relative to your

suggestions.

1. We do strongly advise that patients leaving the US should line up their

post-surgical care prior to surgery. We also let the patient know that the

cost savings achieved by going to Mexico may be offset by increased costs

for follow up care (either by returning to Mexico or to a US surgeon).

2. INAMED does not want to have a support group and most support groups

would not want INAMED in the Group for obvious biases. However, any patient

that contacts INAMED with a question or problem will have an answer from

us. We are always available on a one-on-one basis. Keep in mind that we

are not (and most self appointed experts too) qualified to give medical

advice. There is a legal liability in giving medical advice and advice from

a corporation (or an individual) can be questionable when it is given by

e-mail or phone to a person whose circumstances are not well known. Our

preference is that the patient contact their surgeon with their questions or

issues. Naturally there are many questions that we do answer.

3. Online chat rooms can be a good source of information but it is not

always correct and the information is always anecdotal. You are correct in

that caution should be used if this is the main source of information for a

patient.

4. We do provide very basic after-care information and depend upon the

surgeon to provide additional information. Because there are many

differences in surgeons' opinions we would not presume to publish our

opinion. It would not be possible for us to agree with all the various

surgeons' opinions. It is the surgeon's job to practice medicine not

INAMEDs.

5. I do agree that INAMED can always do a better job of assisting patients.

Answering questions, writing insurance appeals and providing patient books

and videos are all being provided now. These items are available through

your surgeon's or doctor's office. Many patients' meeting are supported and

attended by INAMED. I personally have attended several.

6. Band surgeons are well trained in follow-up care and know full-well of

its importance. We actually do recommend to the surgeons that we train that

they see all patients that come to them for service. However, there is no

way that we can dictate to a surgeon how he/she should practice medicine or

what patients they should accept. For many US surgeon the issue is one of

malpractice insurance. When they see the patient of an international

surgeon the US surgeon accepts the liability of that surgery much as they

would for one of their own patients. Simply put, the surgeon may feel that

they have not been compensated for the risk involved. For many US surgeons

they are to busy with their own patients follow-up to include patients of

other surgeons. This often not only extends to international patients but

to patients of US surgeons moving to a new location.

This month we are sponsoring the first workshop for doctors (not surgeons)

to learn band patient management issues. In other words we are training

" fill " doctors to support patients who have surgery out of the country or

move within the US. This and future workshops like it are an effort to help

with the problem which you stated.

7. None of my comments are meant to suggest that generally speaking the

band surgeons in Mexico and their facilities are not very good. Most are

excellent as are the Mexican hospitals. We would like all patients who

consider going to Mexico for surgery to be completely informed of all the

issues before making a decision.

Your comments are appreciated and we are taking steps to be more supportive

of all band patients.

Regards and best wishes with your band,

Don Mills

INAMED Health

Bill Hermes,Portland OR.5/20/03,-47lbs.