admin – Dr Shooter – Arthroplasty Practice

December 5, 2017December 7, 2017

“No Long Term Benefit” for Robotics

An interesting article “Robot wars: knee surgery marks new battlegroud for companies”, showing the big prosthetic companies are racing to get robots in to hospitals ($$$), but there’s little independent evidence they make a difference. Just seen on Twitter today, a comment from an orthopod attending the prestigious European Knee Society meeting in Copenhagen – “no long term benefit” for robotics.
Sure, they can make your bone cuts more reproducible and more “accurate”, whatever that means; but there is still no evidence that those particular metrics make any difference to long-term patient satisfaction, or revision rates . . . there is still a role in complex pelvic surgery, but not routine knee replacement.

View the Tweet click here.

November 29, 2017December 7, 2017

Blood Clots, Orthopaedics and Joint Replacements

These days, even amongst lay people, there is a pretty well known relationship between big operations and blood clots, With joint replacements, clots are common enough that we routinely give people blood thinners to prevent them.
Why are clots bad? Well, they hurt; they can cause swelling in the affected limb, which can cascade on to a whole other bunch of problems. They can grow, and bits can break off and go to your heart, lungs or brain which can have serious effect on your health. On the other hand the risk with blood thinners, is they make you bleed; a bleeding surgical wound has a higher chance of infection, takes longer to heal, and will often leave you with a stiff joint.

There is ongoing tenions between physicians, who want to give powerful blood thinners, and surgeons, who want your joint to work afterwards!
Dr Shooter will usually use aspirin in low risk patients. New research confirms the results are as good as anything else out there! Click here to learn more on the new research into aspirin use in joint arthroplasty.

September 16, 2017December 7, 2017

Out of Pocket Costs – What are the realist fees patients will pay?

In a recent article “Australians being hit for huge out of pocket surgery costs”, surgeons (particularly orthopaedic surgeons), were questioned about the huge out of pocket costa for surgery. It is important to break this down and to understand the cost that can be associated with private healthcare for patients.

Firstly, yes it is true that some surgeons charge more than others, and some patients will end up more out of pocket than others. Patients need to understand that if they don’t like what a surgeon is charging they can go see someone else. Patients don’t need to stay with the specialist recommended or advised by a GP. Additionally, cost is no guarantee of quality. I advise patients to do their research and to be well informed.

So lets break down the costs for a hip replacements. As per the article $30,000 might sound terrible! But this is not the amount given directly to a surgeon and would more likely represents the total cost of hospital stay, including the prosthesis (which will be the single highest cost), the surgeons fee, the assistant, the anaesthetist, theatre fees from the hospital, bed-stay fees, pharmacy, and physio. Looking at all of that, $30,000 is actually pretty good value.

The surgeons fee is only a small percentage of the “$30,000”. For example hip replacements surgery via the MBS Schedule fee is $1317.80. Medicare ie the government, via your taxes, contributes 75% of this ie $988.35. Your health insurer, for example the insurer Medibank is required to pay the remaing 25%, ie $329. If you surgeon agrees to “No Gap” or “Known Gap” (nothing out of pocket, or up to $500 out of pocket), Medibank will reward the surgeon by giving them a % top up. Currently, the total payment from Medibank for a No / Known Gap hip replacement is $2000; this is made up of $988.35 from Medicare, and $1112 from Medibank. That payment is then expect to include follow up afterwards; by convention this is usually 12 months.

So, to summarise in my practice (Dr Shooter), I will charge a “No Gap” and “Known Gap” for hip replacement surgery with Medibank (again using Medibank as an example only) . So when it actually comes to my cost and estimate “Out of Pocket” costs related to surgery then a patient can expect to pay $0 up to a maximum of $500. Now another surgeon may not participate in “No Gap or Known Gap” billing with Medibank. This is when patients can be billed hundreds or even thousands of dollars out of pocket. Therefore it is important for patients to understand the options, research and be very well informed.

Dr David Shooter offers “No Gap” and “Known Gap” billing to all patients privately insured with Bupa, HCF, Medibank Private or the AHSA group (eg TUH, Navy, CUA, Credicare etc). Additionally, patients that do not have private health insurance but wish to have surgery privately with Dr Shooter can now apply to ZipMoney for interest free and flexible payment options*. All patients will require a referral to see Dr Shooter. Contact us today with any questions.

*Conditions apply to patient wishing to access ZipMoney, click here to learn more.

August 17, 2017December 7, 2017

Is Private Healthcare in Crisis?

The media are publishing so much around the rising cost of private healthcare and claiming the rise is a reflection of how specialist or private doctors charge. Lets look at the facts:

1) The private system currently does close to 75% of elective surgery in Australia. What do you think will happen to the public system, already acopic, if they suddenly have even a 10% increase in more patients to deal with?

2) The public system, particularly in Queensland, recognises that they are inefficient, and is currently directing public patients in to the private system; in Qld, its called Surgery Connect.

3) According to APRA (the Australian Prudential Regulatory Authority), the average gap for FY1617 was $304.

4) According to APRA, the private health insurance industry in Australia made a net profit (ie after tax) of 1.5 billion dollars for FY1617, which is a 100 million dollar increase from the year before. This is despite around 130 000 people dropping their insurance, and having around 150 000 less “episodes of care”.

How on earth does this represent a crisis in private health care in Australia, apart from the poor policy holder?