Free Market Orthopedics and Spine Surgery: Bringing It All Together

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Those of you who have been following our series have now been presented with extensive information regarding principles of free market medicine. We described bundles, the importance of transparency, and knowing what should be included within bundles.  We extended the transparency concept to include outcomes and how they affect the full-burden cost of medical treatment. In the previous issue, we elaborated upon where one might be able to find and access these transparent providers. Now, we will bring everything together so you can hopefully enter the world of free market medicine with greater confidence.

That confidence begins with transparency. Although healthcare, especially specialty care, is a very technical and complex topic, it should still be treated like every other product or service.  Consider that most of us could not build the car in our garage or the refrigerator in our kitchen, yet we effectively shop for value when we buy these products every day.

In healthcare, you should shop similarly. You want to know what is included in a bundle; i.e. what you are buying, such as itemized lists of providers, facility and disposable products. Be certain there are no additional bills coming from anyone related to the episode of care you are purchasing.

Also discuss outcomes including success and complication rates. The success will translate directly into patient satisfaction, and the complications will do the opposite, in addition to driving cost much higher.

A small, private surgical facility with steady traffic and a track record of several years must be doing things well.

When assessing outcomes, do not be afraid of the overwhelming medical jargon. Keep things simple. Most medical professions have standard benchmarks. Ask the provider what those are and how they stack up. If they cannot readily provide an answer, proceed with caution. Someone not tracking outcomes is not likely concerned with them. Ask targeted questions like rates of infection, transfer and readmission. These numbers should be extremely small; i.e., lower than 1% and approaching zero. Likewise, be careful of someone claiming zero complications; you need to question their volume and honesty. Statistically, even the best provider will have some complications if he or she is actively practicing.

Consider what may seem unconventional places for these high-quality providers and facilities. It is tempting to go to the giant regional healthcare system because that is likely the name you know. They may provide excellent care, but often do not provide high value because the market does not demand value from them. They can rely upon name recognition alone allowing them to compete in a different way than a smaller business might.

Think about choosing a place to dine out. McDonald’s is likely one of the most pervasive and universally recognized names in your area. Is it the best value meal? My kids play travel soccer, and this past weekend we went to a diner in the town where we played. It was an inconspicuous place, but the lot had several cars. As one might expect, the food and selection were great, and I paid less than I would have to feed us at McDonald’s. Healthcare is similar. A small, private surgical facility with steady traffic and a track record of several years must be doing things well. It survives solely upon its value and reputation because it cannot rely upon a multi-million-dollar advertising budget and billion-dollar brand to draw customers. It competes using its record, not some other manufactured perception or mythology.

Therefore, I encourage you to go and explore all your options. If you are like many businesses, the rising cost of healthcare is not sustainable. Long-term survivorship requires a new way of thinking and adoption of a new model for purchasing health services. While change can be difficult, remaining on a path to extinction, because it is perceived as easier, is not prudent.  Hopefully, this series of articles has provided enough information for you to have a foundation for discussions within the free market medical arena.

Free markets are, in my opinion, the only way to empower the consumer; certainly, they empower the consumer far more than the current monopolies held by big insurance and hospital systems. So, try the “red pill”, unplug yourself from the matrix, and perhaps we will meet on the other side.