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"Will You Remove My Mole?"

Posted Sep 11 2005 12:00am

In years gone by, I spent far too much time removing small skin lesions in the office. At the time, I was sharing space with another doctor who was profiting by any service I provided. His staff scheduled me with tons of things that simply made me no money. The facts of life are that medicine is a business and when I am paying a huge chunk of change to overhead, I need to make that back or I operate at a loss.

Patients don’t understand why I cannot remove their moles for what their insurance pays and make a profit. Well, I can’t. And now Medicare has stopped paying for things like this as well.

The materials used in the office for surgery (drapes, medications, needle, sutures, blades, instruments, instrument maintenance and sterilization, etc.) are not reimbursed by insurance companies.

A year or two ago, I removed a cyst from a patient’s eyebrow. My costs in materials alone (not counting rent, employees, insurance, etc) were about $65. The insurance company paid $93 and 8% of that went to my billing company. This is no joke.

This is a reason why you won’t see me doing cosmetic dermatology anymore.

Insurance companies must pay enough for a surgeon to make a decent profit. “Covering” a procedure at below overhead rates really means nothing except that surgeons won’t operate.

Until Later,

John Di Saia MD

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