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Shopping for a knee replacement?

Posted Jul 27 2010 12:00am

I was just about to turn off the TV (Today Show) this morning and come down to start working when I saw an ad by Smith & Nephew.  Now, if you haven't been hanging around hospitals and ORs, you may be asking yourself  "Who is Smith & Nephew and what do they do/sell?

Orthopedics in the OR is big business.  The screws, nails and other implants can get a little pricey and just like anything, there is always something, new, better, stronger and spark-lier.  One of the vendors in this space is Smith & Nephew and the add I saw was for knee replacements. 

Orthopedic implant vendors put pressure on the hospitals who are only reimbursed a certain amount of money for any procedure to buy their particular screw, nail, or or other implant.  Just like with cars, there are the expensive models and the practical models.  Hospitals prefer the practical because payors don't reimburse anything extra for a more expensive implant.  So, the ortho implant vendors really push on the surgeons to ask/demand their implants.

Within the hospital environment, the medical staff and administration must balance the desire for cool new products with what can be afforded -- whether it is prescription medications or the latest and greatest knee replacement.  Now, just as we have seen with pharmaceuticals, the ortho implant vendors are taking their sales pitch to the public and the next time one of my mom's sisters or brothers needs a knee replaced, they may ask for that one Smith & Nephew advertises on TV - not realizing the cost or that they really don't need that fancy knee implant.

So, as a society, and with this looming healthcare reform package, we have some choices to make.  Healthcare reform isn't going to solve all of our healthcare delivery system problems by itself.  We individually have to take specific action to make our own choices based on complete information.  And, if we want the best and coolest implant, be prepared to pay for it.  (Now that brings up the historic cry of "well what about the people who can't afford it".  Don't think this health reform package is moving us away from this.)

I also just happend to receive in the mail my Congresswoman's "Health Care Reform Report" in the mail last night.  It describes all of the "good" things about health reform.  What it doesn't address, and this is unfortunate, is that many consumers will have to give in order for others to get and that means changes to how healthcare is delivered.  We can expect to see much more efficient healthcare processes and that will change how you experience your healthcare. 

  • Plan on seeing physicians only for the more complex or specialized care and nurse practitioners and others for more routine care.
  • Expect to be held accountable for your poor health choices by those who pay for your healthcare.
  • Know that technology will replace caregivers for some monitoring and care functions.
  • Understand that there will be surges in healthcare demand over the next few years as the health reform package becomes operational and this will create bottle necks until the workforce can catch up.  This will cause some of us to wait longer for appointments, procedures and access to the care we want as those who need it get moved to the front of the line.
  • Realize that you will have to take a more active role in being informed and participating in your healthcare decisions.

I'd like to challenge those who make our laws to incorporate the realness of the health reform package in their newsletters, speeches and interviews.  I'd like to challenge the consumers of healthcare to really question any healthcare product ad, discuss it with their physician or nurse practitioner, and to realize that the product may not be right for you or that an equally effective and less expensive option exists.

Only then, will we have true health reform!

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