Patient perceptions of physician reimbursement for spine surgery.

Study Design. Anonymous patient survey. Objective. To determine what patients think surgeons should be paid to perform elective spine surgical procedures, and gauge awareness of actual Medicare reimbursement. Summary of Background Data. With increasing transparency, the public may become aware of physician reimbursements and may be a part of the debate regarding appropriate reimbursement. It is unknown what patient's perceive that spinal surgeons deserve to be, or are actually, paid to perform spinal procedures. Methods. Two hundred anonymous surveys were given to consecutive patients in an outpatient office setting by means of convenience sampling. Patients were asked how much they think physicians are and should be reimbursed for typical spine procedures; and they were asked about their opinions of the actual reimbursement amount for these procedures. It was made explicit that the fee in question included only the surgeon's reimbursement and not that of the hospital. Data were tabulated, statistical comparisons were made, and results were correlated with demographic information. Results. On average, respondents thought that surgeons should be paid $21,299 for performing a lumbar discectomy and estimated that Medicare actually pays $12,336 (actual average reimbursement $971). Similar disparities were seen for the other procedures. The vast majority of respondents thought that the average Medicare reimbursement for spine procedures was too low. For example, 92.2% of patients thought that $971 for a lumbar discectomy was "too low," 6.1% thought it was " about right," and only 1.6% thought that $971 was "too high." Conclusion. Patients think that orthopedic spine surgeons should be compensated over 10 to 20 times more than current Medicare reimbursement rates. Patients overestimate the actual amount that Medicare reimburses by a factor of approximately 7 to 10. Less than 10% of patients think that the current Medicare payment is about right, and less than 2% think that surgeons are overpaid.