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Surgical Upselling
Do you want to add a junior mint to your heart surgery for only 49 cents more? | |
Medicine is shameless business in the United States.
Proposed is yet another way to pad the profits of the
industry (tongue in cheek).
When a patient undergoes a surgical procedure (ranging
from major dental work to brain surgery), they're already
in a clean operating room and under the influence
of
anesthesia. Why not suggest other procedures while they're
in there? These procedures might not be medically urgent,
but the differential cost of keeping the patient under for a
few more minutes might make them worthwhile. Teeth
cleaning comes to mind. Perhaps they could do cosmetic
surgery and take advantage of the fact that the insurance
company already approved anesthesia for a different,
medically necessary purpose.
This would hopefully expose the sad state of the American
medical industry, too.
Edited because I was likely drinking when I posted this
were you thinking of the Seinfeld episode? haha
http://en.wikipedia...iki/The_Junior_Mint
[xandram, Jan 27 2012]
[link]
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// the insurance company already approved amnesia for a different, medically necessary purpose. // |
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The amnesia referred to no doubt being related to the huge increase in insurance premiums ... |
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Amnesia is, in fact, one of the three principle
purposes of the drugs anesthesiologists use, the
other two bein analgesia and anesthesia. |
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There are a number of practical problems with this
idea. One of the boring ones is that the informed
consent process is thickly encrusted with
paperwork designed to ensure this doesn't
happen. Another is: the patient isn't the one you
have to convince at the last minute, it's the third
party payer. |
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I have seen, no joke, a surgeon, in the OR, on the
telephone with an insurance company
customer service agent, arguing about whether
the procedure was necessary. |
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"You'll be pleased to know that your triple bypass
was a complete success, Mr. Thenerd. Or, should I
say, Miss Thenerd." |
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This sort of multiple uses of anesthesia is used for
developmentally disabled people who cannot
cooperate - they get teeth cleaned, pap smear etc.
all back to back and all under anaesthesia. I thinkit
is not more generally done because it is expensive
and anesthesia is not without risks. |
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"Sorry sir, only Gold Card patients get pain relief that actually works" |
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My ex-girlfriend is from Colombia and she told me
a
story about her aunt. Cosmetic surgery is a big
thing
over there, and this aunt of hers had been bought
a
present of chest implants. She gleefully went
under
the knife, completely sedated and awoke with a
lovely pair of larger, firmer breasts. |
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However, the surgeon, for some still
inconceivable
reason, had taken it upon himself to give her a
little
present of his own. While she was under he
decided
to give her bottom implants as well, apparently
out
of the kindness of his heart, for he did not charge
for
the service. Unfortunately, within a few months'
time they began to droop to resemble a damp bag
of
potatoes. |
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This is weird. [Eleventeenthly] had a minor
operation two days ago and both he and i
independently thought of this idea before it was
posted. |
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I like the teeth cleaning idea. Usually the OR dentist is idle during heart surgery. |
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// used for developmentally disabled people who cannot cooperate // |
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Please forgive the amnesia (no pun intended). I was actually thinking of anesthesia. |
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As it happens, there's a theory that general
anaesthesia is essentially amnesia, and i thought you
were referring to that. |
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//a theory that general anaesthesia is essentially
amnesia// |
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Meaning that you feel everything, but just don't
remember when you wake up? I don't think that's
right, since local anaesthetics clearly do block
pain, and it's unlikely that generals and locals
would work in completely different ways. |
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But your theory does raise an interesting point: if
general anaesthesia was just "amnesic", and if I
was in agony during the operation but unable to
remember it afterwards, does that leave me
happy to have an operation under general
anaesthesia? It shouldn't, yet it does. Discuss. Or
not. |
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It's not my theory and i don't think it works either
but it is interesting. There are supposed to be
sleeping pills which do that, according to Derek
Parfit, who claims to have found notes from
another
version of himself under his razor some mornings. |
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I think the idea is that they temporarily remove
the ability to establish new memories. However, i
can't see how something that specific would
happen for something which seems not to work in
the usual pharmacological ways, but more like
nitrogen narcosis. |
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My wife has been under general anesthesia several times, and there does seem to be definitie amnesiatic element to it. When they first bring her to the recovery room, she will typically ask a question about the result of the surgery. A few seconds after I answer she will forget that she asked and ask the same question over again. Every time I answer, the amount of time it takes for her to forget gets longer and longer, until the last time when she finally remembers. So I try to answer nicely every time because I never know when she will quit forgetting. |
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I don't remember the source, so it may not be true, but I heard that they used to use an anesthetic on infants that didn't actually cause unconssiousness, but just paralysis. So the baby could feel and remember it all, but wouldn't react. If you had only an amnesia inducing medicine as [MaxwellBuchanan] suggested, you would have the problem of the patient thrashing around while being cut, but if you paralyze them AND prevent them from remembering, you'd need some kind of brain activity mointor to even tell if there was pain or not. |
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It's interesting: if a surgeon said that the operation
would be safer if you were paralysed (but not
anaesthetized) and completely prevented from
remembering any of it, would you agree to it? |
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Interesting that you even ask. |
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That, by the way, is The Arabian Nightmare: "an
infinity of torment experienced in sleep. The
sufferer, awakening, remembers nothing of this
horror and goes all unaware to the next night's hell." |
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Hang on. That sounds like my job. |
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depends: how thoroughly is my brain and body going to be trashed ? There's damage that can be done by the body's response to pain. |
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//The Junior Mint// Tres apropros, [xandram]. I happened to see that episode tonight. Thanks for joining the dots. |
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...sort of happens, having my shoulder x-rayed in Cairo 1992 and the radiologist asks me for a tip while I'm still on the table... |
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Who's gonna turn down a Junior Mint? It's chocolate, it's peppermint;
it's delicious! |
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Excellent Idea, Mr. [thenerd]! This could blossom into an entire cottage industry selling (in addition to the obvious cottages and cottage cheese) all manner of gifts and accessories. The more upscale surgical centers could feature high end boutiques with obscure designer labels (...like Rainier Beer? Hoo Nose, maybe it will make a comeback; but I digress...) |
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Take two buns [+] [+] and call me in the morning. |
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//if a surgeon said that the operation would be safer if you were paralysed (but not
anaesthetized) and completely prevented from remembering any of it, would you
agree to it?// |
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How far back are you unable to remember anything? Would you be fully aware and
presumably in agony during the operation, but once it was completed you'd
remember nothing of the procedure? Or would you just constantly be thinking to
yourself, "I say, this fellow wearing a surgical mask seems to be causing me
excruciating pain. I wonder what that's all about. And, hey, why's this fellow with
the surgical mask causing me excruciating pain?" |
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Either way, I'm not sure how you tell the difference between that and just being
asleep the whole time. So, if it's safer, then sure, no question. Given the choice
though, I think the most intriguing scenario would be the latter of the two, but
with only a hazy recollection of the procedure afterward (perhaps not remembering
the excruciating pain bit). |
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Here's another question though: What if you could be given a form of anesthesia
that doesn't reduce the pain at all, but makes you completely indifferent to it while
it happens (without otherwise modifying your mental state)? |
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"Mr Jones? No, don't try to get up, you're still on the
table - we just wanted to know, this pancreas looks
kinda swollen, do you want a replacement for only
$4995? Okay, will do, you can go back to sleep
now..." |
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//a form of anesthesia that doesn't reduce the pain
at all, but makes you completely indifferent to it//
You've never spent a very long time in the same job,
have you? |
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//a form of anesthesia that doesn't reduce the pain at all
// |
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Anesthesia doesn't have anything to do with pain. It puts
you to sleep. |
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// but makes you completely indifferent to it// |
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It's called Versed. It also has the convenient side-effect of
completely erasing your memories of whatever transpires
while you are under its influence. |
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