Surgeons and hospitals may opt not to perform procedures on patients who are very overweight or old, have preexisting health problems and/or complications that increase risk for poor surgical outcomes. In addition to concern for the patient, providers worry that high-risk patients could endanger their bottom lines for several reasons…

Insurers sometimes pay surgeons and hospitals a flat fee for a procedure. Unhealthy patients are more likely to need long hospital stays, making them less profitable.

Medicare links reimbursement rates to providers’ medical outcomes, such as ­surgical success rates.

Patients and families sometimes sue when surgical procedures fail.

The rejection typically is presented as concern for that patient’s well-being—and that may well be true. Note: A patient is unlikely to be turned away in an emergency situation—emergency rooms are not allowed to refuse patients.

If a surgeon declines to operate due to concerns about your health or fitness: Ask whether there’s anything you can do to bring that risk down.

If there is no way to become a less risky patient and you are committed to getting the procedure, you’ll have to find a surgeon or hospital willing to work with you. Your primary care doctor might be able to provide recommendations.


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