Patients Weigh in on Orthopedic Surgeons' Pay, Reimbursement

When told of the reimbursement payments, patients found them too low and said they would be willing to pay more out-of-pocket costs. Patients also believe a surgeon should be compensated more for having advanced medical training.

The study, published in the September/October issue of Orthopedics, comes at a time of heightened awareness about health care costs, increased access for health care insurance, reductions in surgeon reimbursement payments and the shift to tie Medicare and insurance reimbursement to quality outcomes.

It also adds to the increasing body of research involving patients' perceptions of surgeon reimbursement in the specialty area of orthopedics. The study for the first time examines patient perceptions of orthopedic surgeons who perform arthroscopic knee surgery and anterior cruciate ligament, or ACL, reconstruction -- two of the most common orthopedic procedures performed today.

"Our study demonstrates that patients place a higher value than what is reimbursed for these types of procedures and are willing to pay more out of pocket costs," says Kelechi Okoroha, M.D., a fourth-year resident in Henry Ford's Department of Orthopedic Surgery and the study's lead author. "When told of the actual reimbursement payments, patients believed the payments should have been at least five times more than the current value."

The study involved surveying 231 patients between April and June 2015. The patients were nearly equally split by gender, ranged in age from 18 to 87, and 77 of them had previously underwent knee surgery. They were asked to give their opinions to a series of questions including whether physicians are overpaid, whether their salaries should be cut, whether the salaries should be linked to outcomes, and the best way to lower health care costs. They also were asked questions related to a surgeon's reimbursement for knee surgery. Key highlights:

• Nearly 90 percent of patients say physicians are not overpaid and their salaries should not be cut. • 61 percent of patients say a surgeon's salary should not be tied to outcomes. • 79 percent of patients say reimbursement to drug and device companies should be reduced.

When asked to estimate the Medicare reimbursement payments, patients said $5,442 for arthroscopic knee surgery and $6,667 for ACL surgery. The actual reimbursement payments are $576 and $1,013, respectively.

Patients also said they would pay out-of-pocket costs of $2,286 for arthroscopic knee surgery and $3,517 for ACL surgery.