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.
