from ATLANTA BUSINESS CHRONICLE, September 22-28, 2000

Online bidding for surgery may not make the cut
By Julie Bryant, Staff Writer

Doctors say patients who bid for surgical services online could be walking onto a medical minefield.

In the past year dozens of Internet sites offering name-your-own-price bidding for surgery have sprung up across the country.
Buying airline tickets at Priceline.com may be one thing, but auctioning off delicate medical procedures is sending the wrong message, says Atlanta plastic surgeon Dr. Brian Maloney. “Making money the prime determinant for seeking out a doctor puts other issues on the back burner - like quality and training,” said Maloney, co-director of Premier Image Cosmetics & Laser Surgery in Atlanta.

Maloney said a patient's primary concern should be whether or not their doctor has proper credentials and is performing surgery in an accredited facility.

Most surgery bidding sites, such as Bidforsurgery.com, primarily deal in elective surgeries, including cosmetic procedures, and some dental and eye laser surgery. Because these procedures are not typically covered by insurance companies, which can cap surgery fees, doctors can name their price.

Users log on and select a procedure and then are led through several steps before making their bid and ultimately finding a doctor that will match their price.

Unfortunately, Maloney said, these sites are most likely attracting younger consumers who tend to have less disposable income and even less experience making health-care decisions.

“It just sets you up for trouble,” he said.

No surprise that cosmetic surgeons have raised the most clamor about the sites. Online bidding could pave the way for pricing wars.

The American Society of Plastic Surgeons recently announced it would take a closer look at the spreading phenomenon and plans to issue a formal consumer warning statement later this year.

“Investing in cosmetic surgery online is not like Internet shopping for furniture or a car,” said plastic surgeon Dr. William E. Silver, also co-director of Premier Image Cosmetics & Laser Surgery.

Meanwhile, site developers say, why not?

Atlanta-based WebHealthy.com Inc., which opened its cyberdoors earlier this year, offers consumers more choices, said company President Brent Layton. The company uses the same physician credentialing procedures used by HMOs and PPOs to select their physicians, he said.

“Any PPO directory has the provider's name and the address and phone number of the practice,” Layton said.

WebHealthy goes a step further and offers biographical information on each of its member physicians, including whether or not the doctor is board certified, Layton said. Most health plans also do on-site credentialing of doctors every two years. Layton said that is something the company is considering.

Users also don't automatically get what they bid for. An initial exam with a physician is still required before any surgery is performed. At Bidforsurgery.com, users are directed to information screens that explain the risks of certain procedures and give details about what can be expected in recovery.

So far the sites have attracted interest, but have not yet garnered mass appeal. WebHealthy reported 3,000 people had actually used its site but could not say how many of those 3,000 ultimately made a bid and purchased services from one of its member physicians.

WebHealthy, which recently moved its headquarters from Tampa, Fla., to Atlanta, plans soon to switch from dealing solely with consumers to offering online services to employers, Layton said. The idea, he said, would be to give employers a way to close up the gaps in benefits coverage they offer their employees.

As for bidding for medical services online, Layton said consumers are no more at risk using his company's site than they are using a doctor recommended by their health plan.

But with the national push for consumer choice gaining momentum, surgeons are growing nervous that patients may be asked to make health-care decisions they are not qualified to make.

Maloney and Silver recommend consumers ask some basic questions when choosing a plastic surgeon, including whether or not the doctor is board certified and under which specialty he or she is certified.

They also recommend asking for before and after pictures of other patients who have undergone similar procedures, getting details about the risk and potential complications of the surgery they want and asking the doctor if or she has medical malpractice insurance.

Dr. Brian P. Maloney
Facial Plastic Surgeon
Atlanta, GA
(404) 252-5438