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Surgical Upselling

Do you want to add a junior mint to your heart surgery for only 49 cents more?
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Medicine is shameless business in the United States. Proposed is yet another way to pad the profits of the industry (tongue in cheek).

When a patient undergoes a surgical procedure (ranging from major dental work to brain surgery), they're already in a clean operating room and under the influence of anesthesia. Why not suggest other procedures while they're in there? These procedures might not be medically urgent, but the differential cost of keeping the patient under for a few more minutes might make them worthwhile. Teeth cleaning comes to mind. Perhaps they could do cosmetic surgery and take advantage of the fact that the insurance company already approved anesthesia for a different, medically necessary purpose.

This would hopefully expose the sad state of the American medical industry, too.

Edited because I was likely drinking when I posted this

kevinthenerd, Jan 25 2012

were you thinking of the Seinfeld episode? haha http://en.wikipedia...iki/The_Junior_Mint
[xandram, Jan 27 2012]

[link]






       // the insurance company already approved amnesia for a different, medically necessary purpose. //   

       The amnesia referred to no doubt being related to the huge increase in insurance premiums ...
8th of 7, Jan 25 2012
  

       Amnesia is, in fact, one of the three principle purposes of the drugs anesthesiologists use, the other two bein analgesia and anesthesia.   

       There are a number of practical problems with this idea. One of the boring ones is that the informed consent process is thickly encrusted with paperwork designed to ensure this doesn't happen. Another is: the patient isn't the one you have to convince at the last minute, it's the third party payer.   

       I have seen, no joke, a surgeon, in the OR, on the telephone with an insurance company customer service agent, arguing about whether the procedure was necessary.
mouseposture, Jan 25 2012
  

       "You'll be pleased to know that your triple bypass was a complete success, Mr. Thenerd. Or, should I say, Miss Thenerd."
MaxwellBuchanan, Jan 25 2012
  

       This sort of multiple uses of anesthesia is used for developmentally disabled people who cannot cooperate - they get teeth cleaned, pap smear etc. all back to back and all under anaesthesia. I thinkit is not more generally done because it is expensive and anesthesia is not without risks.
bungston, Jan 26 2012
  

       "Sorry sir, only Gold Card patients get pain relief that actually works"
hippo, Jan 26 2012
  

       My ex-girlfriend is from Colombia and she told me a story about her aunt. Cosmetic surgery is a big thing over there, and this aunt of hers had been bought a present of chest implants. She gleefully went under the knife, completely sedated and awoke with a lovely pair of larger, firmer breasts.   

       However, the surgeon, for some still inconceivable reason, had taken it upon himself to give her a little present of his own. While she was under he decided to give her bottom implants as well, apparently out of the kindness of his heart, for he did not charge for the service. Unfortunately, within a few months' time they began to droop to resemble a damp bag of potatoes.
theleopard, Jan 26 2012
  

       This is weird. [Eleventeenthly] had a minor operation two days ago and both he and i independently thought of this idea before it was posted.
nineteenthly, Jan 26 2012
  

       I like the teeth cleaning idea. Usually the OR dentist is idle during heart surgery.
phundug, Jan 26 2012
  

       // used for developmentally disabled people who cannot cooperate //   

       What, like Congressmen ?
8th of 7, Jan 26 2012
  

       Please forgive the amnesia (no pun intended). I was actually thinking of anesthesia.
kevinthenerd, Jan 26 2012
  

       As it happens, there's a theory that general anaesthesia is essentially amnesia, and i thought you were referring to that.
nineteenthly, Jan 26 2012
  

       //a theory that general anaesthesia is essentially amnesia//   

       Meaning that you feel everything, but just don't remember when you wake up? I don't think that's right, since local anaesthetics clearly do block pain, and it's unlikely that generals and locals would work in completely different ways.   

       But your theory does raise an interesting point: if general anaesthesia was just "amnesic", and if I was in agony during the operation but unable to remember it afterwards, does that leave me happy to have an operation under general anaesthesia? It shouldn't, yet it does. Discuss. Or not.
MaxwellBuchanan, Jan 26 2012
  

       It's not my theory and i don't think it works either but it is interesting. There are supposed to be sleeping pills which do that, according to Derek Parfit, who claims to have found notes from another version of himself under his razor some mornings.   

       I think the idea is that they temporarily remove the ability to establish new memories. However, i can't see how something that specific would happen for something which seems not to work in the usual pharmacological ways, but more like nitrogen narcosis.
nineteenthly, Jan 26 2012
  

       My wife has been under general anesthesia several times, and there does seem to be definitie amnesiatic element to it. When they first bring her to the recovery room, she will typically ask a question about the result of the surgery. A few seconds after I answer she will forget that she asked and ask the same question over again. Every time I answer, the amount of time it takes for her to forget gets longer and longer, until the last time when she finally remembers. So I try to answer nicely every time because I never know when she will quit forgetting.   

       I don't remember the source, so it may not be true, but I heard that they used to use an anesthetic on infants that didn't actually cause unconssiousness, but just paralysis. So the baby could feel and remember it all, but wouldn't react. If you had only an amnesia inducing medicine as [MaxwellBuchanan] suggested, you would have the problem of the patient thrashing around while being cut, but if you paralyze them AND prevent them from remembering, you'd need some kind of brain activity mointor to even tell if there was pain or not.
scad mientist, Jan 26 2012
  

       It's interesting: if a surgeon said that the operation would be safer if you were paralysed (but not anaesthetized) and completely prevented from remembering any of it, would you agree to it?
MaxwellBuchanan, Jan 26 2012
  

       Interesting that you even ask.   

       That, by the way, is The Arabian Nightmare: "an infinity of torment experienced in sleep. The sufferer, awakening, remembers nothing of this horror and goes all unaware to the next night's hell."
mouseposture, Jan 26 2012
  

       Hang on. That sounds like my job.
MaxwellBuchanan, Jan 26 2012
  

       depends: how thoroughly is my brain and body going to be trashed ? There's damage that can be done by the body's response to pain.
FlyingToaster, Jan 26 2012
  

       //The Junior Mint// Tres apropros, [xandram]. I happened to see that episode tonight. Thanks for joining the dots.
spidermother, Jan 27 2012
  

       ...sort of happens, having my shoulder x-rayed in Cairo 1992 and the radiologist asks me for a tip while I'm still on the table...
not_morrison_rm, Jan 27 2012
  

       Who's gonna turn down a Junior Mint? It's chocolate, it's peppermint; it's delicious!
kevinthenerd, Feb 29 2012
  

       Excellent Idea, Mr. [thenerd]! This could blossom into an entire cottage industry selling (in addition to the obvious cottages and cottage cheese) all manner of gifts and accessories. The more upscale surgical centers could feature high end boutiques with obscure designer labels (...like Rainier Beer? Hoo Nose, maybe it will make a comeback; but I digress...)   

       Take two buns [+] [+] and call me in the morning.
Grogster, Feb 29 2012
  

       //if a surgeon said that the operation would be safer if you were paralysed (but not anaesthetized) and completely prevented from remembering any of it, would you agree to it?//   

       How far back are you unable to remember anything? Would you be fully aware and presumably in agony during the operation, but once it was completed you'd remember nothing of the procedure? Or would you just constantly be thinking to yourself, "I say, this fellow wearing a surgical mask seems to be causing me excruciating pain. I wonder what that's all about. And, hey, why's this fellow with the surgical mask causing me excruciating pain?"   

       Either way, I'm not sure how you tell the difference between that and just being asleep the whole time. So, if it's safer, then sure, no question. Given the choice though, I think the most intriguing scenario would be the latter of the two, but with only a hazy recollection of the procedure afterward (perhaps not remembering the excruciating pain bit).   

       Here's another question though: What if you could be given a form of anesthesia that doesn't reduce the pain at all, but makes you completely indifferent to it while it happens (without otherwise modifying your mental state)?
ytk, Mar 01 2012
  

       "Mr Jones? No, don't try to get up, you're still on the table - we just wanted to know, this pancreas looks kinda swollen, do you want a replacement for only $4995? Okay, will do, you can go back to sleep now..."
smendler, Mar 04 2012
  

       //a form of anesthesia that doesn't reduce the pain at all, but makes you completely indifferent to it// You've never spent a very long time in the same job, have you?
MaxwellBuchanan, Mar 05 2012
  

       //a form of anesthesia that doesn't reduce the pain at all //   

       Anesthesia doesn't have anything to do with pain. It puts you to sleep.   

       // but makes you completely indifferent to it//   

       It's called Versed. It also has the convenient side-effect of completely erasing your memories of whatever transpires while you are under its influence.
Alterother, Mar 05 2012
  
      
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