Doctors are refusing to operate on smokers. Here’s why the trend will grow.

Macon Telegraph ^ | 2/23/17 | Karen Garloch

[markomalley]

An irate man contacted me recently to complain he’d been turned down for back surgery because he’s a smoker.

“It’s just not right,” said the Charlotte man, who suffers from chronic hip and leg pain. “I need this surgery. It’s to the point where I can’t walk around the block with my dogs.”

He acknowledged smoking is a “bad habit,” but after 35 years, he’s not sure he can quit. And he doesn’t think he should have to.

(snip)

Spector said it’s part of a national trend for doctors to run down a checklist of behaviors in preparation for elective surgery. Before spinal fusion, Spector said he might tell a patient: “Listen, I want you to stop smoking, but if you can’t stop smoking, at least cut it in half. A two-pack-a-day smoker is going to have a higher risk (of complications) than a two-cigarette-a-day smoker.”

(snip)

At OrthoCarolina, Spector said doctors agree that all patients who register for the bundled payment plan must go through “surgical optimization” so they’re as healthy as possible before surgery. At some point, insurance companies may even begin to refuse to pay for elective surgeries on smokers.

[blackbetty59]

They don’t want to operate on people who smoke tobacco, but they will gladly operate on fat people, or diabetics who eat cake. They’ll operate on men who take their sexual organ and put it into the fecal hole of another man. They’ll operate on women who cut off their breasts, and take testosterone. They’ll operate on CEOs who drink their lunch, and the toney pot-smoking yuppies with whom they golf. They’ll operate on men who take estrogen, and wear wigs. But these pillars of virtue will absolutely NOT operate on someone who smokes tobacco. lol

[greatvikingone]

I don’t support except when I’m helping to pay for it. Freedom is supior.

[DOC44]

They are talking about elective surgery. The party electing to have the surgery is the patient NOT THE DOCTOR who is suffering from the GOD SYNDROME.

[BykrBayb]

The insurance company / government is going to have a primary interest in controlling their costs, thus minimizing the risk that the premiums they receive from the pool of insured people doesn't exceed the money paid out to providers

If the customer voluntarily enters into the contract, then the insurance company has a secondary interest in engaging in practices that attract customers. This is not an issue with a captive clientele.

[factoryrat]

Sure, I can see their POV regarding this. If this is the case, how come they say nothing about age, fitness level, drinking, drug use, being overweight, or other risky lifestyle choices? All of those choices are risk factors for complications.

If a doctor warns you that one of the issues noted above will cause problems, listen to them.

On the flip side though, doctors and hospitals won’t guarantee that you will not contract a disease or get an infection from being in their hospital, and will force you to sign a disclaimer attesting to that before you go under the knife.

[RetSignman]

[But these pillars of virtue will absolutely NOT operate on someone who smokes tobacco.}

But if you have never smoked in your life and have an elevated pulse, they have no problem prescribing Amiodarone (Pacerone)and then end up with lungs that sound like you’re a two packer a day.

[SVTCobra03]

If you really believe that smoking is not a leading cause of lung cancer, I have some swampland in Florida I would like to sell you.

[sit-rep]

First, show me where smoking has anything to do with back surgery!! what a crock of bullshit!!

[markomalley]

They don’t want to operate on people who smoke tobacco, but they will gladly operate on fat people, or diabetics who eat cake. They’ll operate on men who take their sexual organ and put it into the fecal hole of another man. They’ll operate on women who cut off their breasts, and take testosterone. They’ll operate on CEOs who drink their lunch, and the toney pot-smoking yuppies with whom they golf. They’ll operate on men who take estrogen, and wear wigs. But these pillars of virtue will absolutely NOT operate on someone who smokes tobacco. lol

Addressing everybody so far who has said something along the lines of "But doctors operate on _______"

I wouldn't necessarily get too upset with doctors on this. Even though I have absolutely NO use for medical insurance companies, I don't think I'd even get horribly upset with them on this either.

I say this because the medical payments market is so tightly regulated by both state governments and FEDGOV that they may have no choice in this. It is politically acceptable for government to have regulations allowing insurance companies to mitigate risk based upon smoking, but:

• If they tried to mitigate risk based upon sexual behaviors (higher disease possibility with some behaviors), there would be screams of "homophobia" (a made up word);
• If they tried to mitigate risk based upon babies being ripped from a woman's womb, there would be screams of "misogyny";
• If they tried to correlate premiums based on zip code (I'm sure there are differences in conditions like diabetes based upon zip code), I'm sure there would be screams of "racism";
• If they tried to correlate premiums based on body fat percentage, there would be other discrimination claims;
• and so on.

And if they refused to provides services based on those particular lifestyle choices, then the screams would be infinitely louder. Politicians are not willing to take that screaming.

Fact is, they are allowed to do this with smokers because it's politically correct...they aren't allowed to do so with other bad lifestyle choices, because those choies haven't similarly been vilified for generations.

This would all be changed if individuals were responsible for the consequences of their behavior. As it stands, those consequences are assigned to a third party (the one who actually pays the medical bills).

[9YearLurker]

The results of the studies have been pretty clear for 50 years. Where have you been?

[markomalley]

First, show me where smoking has anything to do with back surgery!! what a crock of bullshit!!

They say that it causes constriction of capillaries and that reduced blood flow can impair healing after the surgery.

[sit-rep]

they would kill them all and be done with it... only their “healthy” lifestyle need apply!

[9YearLurker]

The insurance companies should be free to do that on their own in the free market.

Obesity and smoking, especially, drive up healthcare costs immensely.

[sit-rep]

ok that’s lung surgery!! This guy in the article is going in for surgery on his back!!

[Eagles6]

True

[deweyfrank]

Here’s the problem. I smoked almost 40 years ago. And only for about three years. Haven’t smoked since. The doctors still have me listed as a “smoker”. They say if you smoked once in your life, you’re a smoker. I say BS. Should I be rejected for an operation because of this?

[sit-rep]

sigh... I understand... This article caught me on my first few sips of morning coffee as I smoke surfing the pearls of wisdom of the day! Scuse me if I got any on ya!!

I just don’t like hearing what I know is right... carry on! ill go back and sit down! ;)

[Gen.Blather]

Very good analysis. Thank you for those thoughts.

[jurroppi1]

The taxes collected on tobacco products that are supposed to cover all of that have for quite a long time far outstripped the cost smokers place on “the system”

Last I heard 4X the actual medical cost was collected by the feds.

[ObozoMustGo2012]

You didnt even read my post. My father had heart surgery. But the point is to avoid infections of reopened wounds.