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Posted on Jan 15, 2018, 5:51 pm
#21

Quote from: The Dreamer on January 15, 2018, 05:48:40 PMHere is the discussion where there are documents speaking about this:
www.limblengtheningforum.com/index.php?topic=3501.0;wap2


In the U.S. medical malpractice lawsuits are public record, easily searchable online. If that's true you should provide the links to these lawsuits. A lot of patients considering Dr. Paley might change their mind.

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Posted on Jan 15, 2018, 5:53 pm
#22

Quote from: Stadiometers on January 15, 2018, 05:51:14 PMIn the U.S. medical malpractice lawsuits are public record, easily searchable online. If that's true you should provide the links to these lawsuits. A lot of patients considering Dr. Paley might change their mind.

Read what I have posted before copy-pasting the same message

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Posted on Jan 15, 2018, 5:56 pm
#23

Quote from: The Dreamer on January 15, 2018, 05:53:28 PMRead what I have posted before copy-pasting the same message


I did read what you posted. My response is the same, for the third time....

In the U.S. medical malpractice lawsuits are public record, easily searchable online. If that's true you should provide the links to these lawsuits. A lot of patients considering Dr. Paley might change their mind.

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Posted on Jan 15, 2018, 7:07 pm
#24

Quote from: The Dreamer on January 15, 2018, 11:25:15 AMWhen you are paying high sums of money (maybe life savings)  and putting at risk your body,they owe you something.Or do you think that doctors like Sarin/Sringari ecc don't have to be blamed ?
When you're doing this kind of operation,your doctor should perform 110% of his possibilities
Prakash for once is right. The majority are thieves.Think about the nail's cost(maximum 10-15.000€) and they are charging ofte 60.000€+ for internals
And Paley belongs to that cathegory,asking 100.000€ and then being fired from Baltimore for malpractice and going to Florida where laws allow him to do everything he wants


The physical therapy department at Paley Institute is billed as part of Paley's total costs. So, if you pay $90,000 for femurs like I did,
about $30,000 of it came from the nail,
about $ 225 * 5 * 12 = $ 13500 came from the physical therapy department.

That leaves $46,500. Now, the Paley Institute is "leasing" facilities from St. Marys. That means they pay fees to St. Marys for using its surgery room, anesthesiologits, nurses, etc.

I don't have an estimate for the cost of that, but lets say an anesthesiologist makes $300k a year (according to glassdoor), then 4-5 hours of an anesthesiologist's time is worth $144 * 5 = $720.

Its not just Paley operating on the patient, theres a team (I think Robbins and Packer). If we were to assume that an orthopedic surgean makes $500k a year (glassdoor), then their time costs $240 * 5 * 3 = $3600.

You end up with around $42k, which covers hospital rent, malpractice insruance, administrative staff, etc.

I didn't even include the costs of the medication and blood bank (for transfusion) during surgery (ie saline solution, etc). Those things are also relatively expensive.
----
Its definitely an expensive surgery, but lets not forget all the costs involved in an elective, cosmetic, non-necessary surgery.

I see no valid reason to complain about the costs.

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Posted on Jan 15, 2018, 7:22 pm
#25

Quote from: Purushrottam on January 15, 2018, 07:07:27 PMIts definitely an expensive surgery, but lets not forget all the costs involved in an elective, cosmetic, non-necessary surgery.

I see no valid reason to complain about the costs.


It all comes down to this, thanks for the breakdown. Sometimes we take for granted that we're breaking functionally perfect legs to fix a problem in our heads.

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Posted on Jan 15, 2018, 11:24 pm
#26

Quote from: Android on January 15, 2018, 07:22:46 PMIt all comes down to this, thanks for the breakdown. Sometimes we take for granted that we're breaking functionally perfect legs to fix a problem in our heads.

Its a social problem, not something only in our minds.

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Posted on Jan 15, 2018, 11:46 pm
#27

Quote from: Body Builder on January 15, 2018, 11:24:30 PMIts a social problem, not something only in our minds.


Yes, the social aspect is what drives us to do it. Height isn't much of a problem if you're the last person on Earth.

Some men actually don't mind, it doesn't bother them; at least not to the point of seeking surgery. For us obviously it does, and we'll voluntarily take the necessary risks to level the playing field.

There are some objectively tall people getting CLL, so it's a mix of societal pressure and our internal struggles to define desirable height.

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Posted on Jan 16, 2018, 12:00 am
#28

Quote from: Android on January 15, 2018, 08:44:22 AMI wouldn't say most doctors are thieves. In the US, cost of living is much higher, and the stricter regulations make things more expensive -- increasing costs for everything from renting operating theaters, equipment, to medication. Litigation is not uncommon either, and costs may be raised in anticipation for such events. Let's not forget that the US healthcare system is also brutally unforgiving without insurance, which CLL (or any cosmetic surgery) doesn't qualify for.

Elsewhere in the world where living costs are lower, I'd say the the increased demand has put a strain on the doctor's workloads, and they've raised prices to dissuade less committed patients. CLL is relatively unknown, but more people are finding out about it every year. They can effectively make the same money without overworking themselves; we as patients don't want to increase risk for error by allowing doctors to take on a handful of surgeries per day either. The solution is to have more specialized doctors to increase supply, and hopefully the increase in demand for CLL and improved surgical methods/equipment will make that possible.

And let's not forget that state-of-the-art internal nails like PRECICE accounts for the bulk of the cost these days. Cost of raw materials doesn't add up to so much, but they have to factor in profit margin, R&D, employee salaries, FDA processing fees, etc. NuVasive isn't the enemy either, since revolutionary products tend to start with high prices to pay for its initial investment.

Here's an interesting article by Dr. Birkholtz from September 2017, precisely about his takeaways of being a doctor as well as becoming a businessman:
Orthopaedic surgery as a business - getting it right

In the end, doctors indeed want to make money, just like all of us. It is a profession and they spent a lot of resources to become an expert in their field. They're not operating a charity and they are not your friend; they don't owe us anything. CLL is a cosmetic surgery, so no one is forcing us to do it. Lucky for us we have the internet, we have airplanes, and we have a lot of doctors to fit our unique needs.


It is no only my opinion. Go to google and write 'most doctors are' and the first hint you get is 'corrupt'. HIV drugs being sold for $150k , really? and when Indian companies made (for poor indians, India's gdp pr cpita $4500) generics, in response the CEO of a big pharma company said 'our hiv drug is for rich westrners not poor indians'. To give my personal life exmaple - I was a student then(had free medical insurance from university) , I had chest pain I went to student healthcare center who sent me to bigger medical college hospital - they kept me for 8 hours did numerous tests and told me at the end - take painkillers !! I said 'for how long?' thy said until the pain goes away! I said what if the pain does not go away in 2 years, 3 yars, 50 years!! they said oh ok - then take for 6 months if pain does not go away come back! Fast forward - I joined job, my student insurance was covering me till october so I decided that I dont need company insurance till January (u can take in june or january) unfortunately I fell down while crossing road in november, I was out of insurance so I went to hospital and told them that I wil pay from pocket and I don't need them to do 100 tests just need an xray to tell me if my hand had broken, they did an xray and gave me a gloves kind of thing to wear - thats it- for that they charged me $1400. Sam kind of stories I hear everyday. do you know the profit margin on medicines? whole medical profession in US is under corrupt clutches. And btw did you know - US govt spends 6 trillion dollars a year for medical of elderly people in US !!

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Posted on Jan 16, 2018, 12:45 am
#29

Welcome to America. My old roommate's appendix burst, we dragged his unconscious 6'3" body into a car since we knew he couldn't afford an ambulance ($700-1200). There's a lot to be angry about when it comes to America's healthcare practices, but it really doesn't translate well for cosmetic procedures.

Yes, it sucks that you had to pay so much for an x-ray, and you're allowed to be upset about it. You had to do it for your own safety, you had no choice. CLL, you do. It's a luxury, not a right. And you've been here long enough to know that there are plenty of affordable doctors who do a good job, so I don't understand the need for anger when we have the freedom to choose our own doctor. It's not like HMO in which we have an assigned doctor.

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Posted on Jan 16, 2018, 12:48 am
#30

Quote from: Android on January 16, 2018, 12:45:34 AMWelcome to America. My old roommate's appendix burst, we dragged his unconscious 6'3" body into a car since we knew he couldn't afford an ambulance ($700-1200). There's a lot to be angry about when it comes to America's healthcare practices, but it really doesn't translate well for cosmetic procedures.

Yes, it sucks that you had to pay so much for an x-ray, and you're allowed to be upset about it. You had to do it for your own safety, you had no choice. CLL, you do. It's a luxury, not a right. And you've been here long enough to know that there are plenty of affordable doctors who do a good job, so I don't understand the need for anger when we have the freedom to choose our own doctor. It's not like HMO in which we have an assigned doctor.


I agree 100% with what you said, but because of demand-supply gap I believe some doctors are overcharging - but you are right - it is our choice - leave it or take it. It is more of frustration then anger - with highest healthcare expenditure in world (taken from our taxes) we get nothing whil Finland, Canada with almost half the spend give free halthcare. 6 trillion of tax money on elderly health expenditure, in a country of 330 million, do the math. Enough to be frustrated and or angry.

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