Join Date: Jan 2008
Location: Jacksonville, FL, USA
Laser Spine Institute (my view)
Hello, everyone. I stumbled on to this forum while researching the cost of health problems in the general population.
I have had endoscopic laser surgery on my neck (C3-C4 discs) and facet joint ablation at LSI in July 2006. The Laser Spine Institute in Tampa, Florida enjoys a reputation that is second to none among the finest medical facilities in this state. My surgery turned out to be everything they said it would be and more.
Before I contracted with LSI to operate on my neck I vetted them, researching their record in great detail (as well as many other facilities and surgeons offering this type of procedure). An occupational hazard. What I found was that LSI had, and continues to have, an unblemished record and an enviable reputation.
ITEM 1: Several people addressed laser surgery at LSI as being new, cutting-edge, experimental, unapproved and unproven, etc.
The arthroscopic laser method of surgery LSI uses is not new at all. It was pioneered in Japan in the late 1970’s and exported to the United States in the early 1980’s, once it had undergone numerous trials and peer-reviewed examinations … or succinctly put, once it had been perfected. The trials that validated their worth were completed overseas nearly 3 decades ago. Here in America we are a bit late to catch on.
ITEM 2: Several people questioned its effectiveness and made comparisons to traditional surgery.
Here are the facts. Open back surgery currently leaves the patient recuperating at home from 6 to 9 months before they can fully return to work. Laser back surgery allows the patient to return to work in 2 to 3 weeks; many report they have returned to work the same week. Open back surgery has a success rate of less than 60%. Laser back surgery at LSI has a success rate of greater than 80% in improving the patient’s quality of life.
The median cost for open back surgery in the state of Florida is $62,545 (including hospitalization for traumatic surgery, home nursing visits, a 6-9 month medication regimen during convalescence, etc.). These costs soar to over $100,000 if the placement of hardware is involved. Cost for laser back surgery at LSI is $29,500 (no hospital stay, no protracted regimen of medication). Open back surgery will often create the development of scar tissue and problems that result from it later. Laser back surgery results in no scar tissue development. Open back surgery often produces collateral damage to the dura matter, adjacent musculature and surrounding tissues. Laser back surgery at LSI does not. In over 6,000 surgeries done at LSI, only one patient had to be hospitalized as a precaution due to numbness in her extremities following surgery, which fully attenuated after 24 hours.
Surgery may not be the only option, as others have pointed out here, but it may be the best one to relieve constant, excruciating pain and laser spinal surgery is the most successful, least harmful, least invasive and least likely to generate additional problems, including scar tissue.
ITEM 3: Some remarked about the cost of the surgery and LSI’s requirement of money paid upfront. And whether these surgeries were approved and covered by insurance.
They are indeed covered by every major insurance plan, including Medicare, in whole or in part. These carriers do not appear to share a consensus of reimbursement or a uniform percentage of repayment, but each of the 5 largest major medical insurance companies pay some amount based on a formula predicated on what they deem usual and customary. LSI has a patient financial services department solely dedicated to working with the patient and their insurance carrier to ensure the customer recoups the maximum compensation allowed. This group works very hard at it and they are graded on how successful they are at securing the greatest remittance for the patient post-operatively. I personally know this to be true because I had Aetna when I had my surgery and Aetna was difficult to deal with – first denying the claim, then agreeing to pay the comprehensive charges, only to remit a paltry sum of small payments and finally, after much dickering, compensated me for 60% of the total cost.
Insurance companies by and large are not proactive when it comes to paying out benefits because the benefit is not theirs. The less they have to pay, the more money they keep and the longer they can stretch out the payment process, the more they earn in invested interest on the pending funds they ultimately will disburse.
Because only you can deal with your insurance company, not any of your providers – beyond that of submitting the claim for reimbursement, LSI gets the payment from you and you get reimbursed by the insurance company. In my case, had they billed Aetna for reimbursement, they would not have been able to come back to Aetna with an appeal for reconsideration. They would have been out the 30 grand. Or they would then have had to “back bill” me and I would be out the 30 grand. “Up front billing” is best for patient and provider alike. And, after all, they are a business and the demand for their services is high.
ITEM 4: One person remarked about lawsuits, linking LSI and its surgeons to the Bonati Institute, saying they all worked there, were trained by Bonati, shared in the firm’s legal problems and only left due to squabbles over who got paid what.
Not true. While several of LSI’s surgeons worked previously with Bonati, the reasons they left had little to do with compensation and everything to do with the lawsuits and competency of Dr. Alfred Bonati. They did not want to be broad-brush implicated or tainted by the increasing number of lawsuits against Bonati, and as an ancillary concern, have their earnings decimated by a judgment against the practice in toto. This is well documented in articles published in the St. Petersburg Times. Since I cannot post links here, you will have to go to their website and search for ‘Bonati’.
If any of LSI’s board-certified orthopaedic surgeons ever received suspect or questionable training under Bonati (and I doubt it), it has long since been rectified under the watchful care and expert instruction of Dr. James St. Louis, chief spine surgeon at the Laser Spine Institute and the American Association of Physician Specialists’ 2005 PHYSICIAN OF THE YEAR for Orthopaedic Surgery. Each surgeon that comes onboard with LSI spends 3 months in rigorous hands-on tutelage with Dr. St. Louis.
None of LSI’s surgeons have been named personally in any lawsuits by their patients, individually or as part of a group.
ITEM 5: Others stated that LSI is not regulated by any authority, implying that if they were, they would not be able to practice medicine and conduct business as they do.
They are indeed regulated and monitored by the various agencies, commissions and departments of the government of the state of Florida. No fewer than 9 different entities oversee the business of surgical centers such as LSI and their attendant surgeons and doctors, chief of which is the Florida State Board of Medicine. Other authorities that scrutinize their operations are the Agency for Health Care Administration, which regulates and disciplines physicians for malpractice, malfeasance, mismanagement and professional misconduct, etc. To name a few more: The Senate and House Committees on Professional Regulation, The Commission on Professional Ethics, The State Board of Health, The Florida Board of Standards and Practices, OPPAGA – Office of Program Policy Analysis and Government Accountability, The American Medical Association (AMA) – Florida Chapter and The Florida Attorney General’s Office. This is not the comprehensive list. There are numerous lesser watchdogs of government that these businesses have to please by compliance. Suffice it to say, they do not get to do anything they choose.
ITEM 6: One person pondered “if these surgeries enjoyed long-term success, why are medical schools not training doctors in this [technique] by now. Lasers have been around for awhile. Major hospitals would offer it and it would be completely covered. ... Two highly reputable doctors I spoke with in Toronto claimed that they know of these clinics scattered, mainly around Florida and California, and they warned me to stay away. They want to make big bucks and they're exploiting the fact that there's desperate people out there who will pay just about anything for the dream of having no pain.”
There are medical schools that are training doctors in these techniques, but not many. The reason stems from a lack of experienced surgeons to teach it. Today there are but a few highly qualified professionals able to perform these laser surgeries that the Laser Spine Institute offers and like anyone in any occupation where the demand is high and the supply is scarce, these specialists can command top dollar, and everyone should know that working for yourself in your own facility beats working for a college or hospital that will dictate how much money you can earn plying your craft on their premises. There is nothing magical about a hospital. Because a surgery is performed in a hospital does not make it any more valid than in any other surgical environment. And insurance companies do not pay more based on the setting.
College professors, including those at medical schools, don’t earn what they could in the private sector and they are usually doctors that have already had long, successful, lucrative careers before accepting noble teaching positions. Since the laser surgery discipline is relatively new, few are at the point in their lives and careers where they are willing to forgo the opportunity to make money in favor of the opportunity to mold minds.
As to where LSI chose to locate, i.e., in Florida, where presumably a greater concentration of the elderly retire and whom are prime candidates for these surgeries, just where would an enterprising business that specializes in back and neck problems locate if not nearest the clientele with the greatest need for their services? And LSI would not be enjoying the flood of success it currently enjoys if their operation was a sham and the quality of its claims of relief not true. There are not enough advertising dollars to overcome bad word-of-mouth publicity in the internet age.
Just look at the number of people and posts logged on to this HealthBoards, seeking and offering help with medical problems. This website offers unfiltered access to the experiences of others who have gone through what others are going through and what remedies others are contemplating. No illegitimate business can long survive under this kind of scrutiny. LSI would not have built a state-of-the-art surgical theatre and spent a fortune on equipment, based on a “get rich quick” scheme that would immediately collapse under the weight of scrutiny, both from the public and the agencies that regulate them.
ITEM 7: Another person questioned the possibility of a LSI promoting a second discounted procedure, stating “Then there is also another thing to be weary of, and that is you will need to have a second surgery to fix a second problem that we see that seems to crop up quite a lot at LSI, for an additional discounted bargain price of $25,500 or thereabouts.”
Often as not, the problem causing your pain and crippling condition radiates from more than one source. LSI is offering to reduce the cost of a second surgery, IF NEEDED. For example, an X-ray or MRI may indicate that a patient has a bulging or herniated disc at L-4/L-5 and another at L-5/S1. The 2 discs are positioned several centimeters apart and cannot easily be repaired laparoscopically within the same surgery. A selective nerve root block (SNRB) is used to pinpoint from where your greatest discomfort stems and which of the 2 herniated discs is most problematic by isolating one at a time with a temporary pain eliminating injection. LSI is not trying to solicit additional business from you, but trying to give you the whole picture. The prognosis may include news you may not want to hear. That prognosis might forewarn though that you may not get total relief from the surgery because you have more than one problem area, BUT that if you do have multiple problem areas correctible by surgery -- and the pain is such that you opt for more surgery -- LSI will perform all additional surgeries at a discounted price (approximately 15%).
I had several more items to address here, but I’ve gone on too long as it is, but suffice it to say that I am sold on the Laser Spine Institute, as I am a walking testament to the effectiveness of the laser surgery they perform there. For 21 years, I suffered with unceasing excruciating pain and severely limited mobility. For 21 years, it was a chore just to get into my car. For 21 years, it was a chore just to put on my socks and shoes. 21 minutes after I had surgery at LSI, I was free from all of those years of pain and restrictions. 21 hours later, I was able to successfully complete every flexibility exercise and examination the physical therapist put me through. 21 days later, I was jumping waves on a jet ski with my niece in the St. Johns River. 21 weeks later, I became an volunteer patient referral for LSI. 21 months later, I am still pain-free and symptom-free … and I’m dancing in the street! GOD BLESS LSI.
Last edited by Administrator; 03-26-2008 at 11:50 PM.
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