Kaiser question

[GoodbyeYellow]

So I went and had my hernia looked at a couple of months ago, doc said that before 65 is the age to do it if at all, it gets more complex with age (I’m 62). Told me to go think about it, and a few weeks later his office called and set up a phone follow up for another few weeks later. Spoke today.

It hasn’t gotten worse (and as you probably know, it doesn’t get better on its own). His entire approach this time was to guide me into electing to do the surgery (laparoscopic, robotic). It started off sounded like he was asking me if I wanted it but not really, mostly the convo was directing me into setting it up.

Which may be fine, but it had a slight feel of being pushed. But I tell myself that if a complication develops and they didn’t push, then they might be on a legal hook and that’s driving the action.

As you know Kaiser self-insures, so it couldn’t be to make money… or could it?

I’m all for getting it if needed. Just feel a bit like it’s more his decision than mine. It’s my first-ever surgery so not really experienced with how these policies work.

Sounds normal?

 

[Another Reader]

With Kaiser, it's never about the patient. It's always about what's best for Kaiser. No doubt some goal has been set by a public health entity or there was a cost analysis that said doing this surgery early for people that would likely need it eventually will result in lower costs to Kaiser and better outcome reports.

To be fair, this happens at other large care organizations. I got tagged for several tests when I first moved to Stanford to meet their objectives for testing under Medicare. I will be saying no to some tests in the future because my personal risk profile is much lower than most and does not justify the radiation exposure.

 

[Aerides]

Kaiser or not, if you are ok waiting, it's always a good idea for a 2nd opinion. But it is true that our body's ability to recover tapers off as we age, so if it's inevitable, sooner is better than later.

 

[Z3Dreamer]

I had a hernia at about age 53. It was not painful. Surgeon said I could wait until it got worse or have the surgery now. Up to me. Did some research. Talked to some folks who waited. They had a painful emergency room experience.

I respectfully disagree with your conclusion that his guiding you to get treatment is all about Kaiser.

 

[EastWest Gal]

Even babies, especially preemies, can have hernias. Girls can have hernias. Hernias in the groin area (the most common place) are at significant risk of complications and should be repaired. Most hernias are not painful most of the time. but if bowel gets into the hernia and gets trapped, not only is it painful, the portion of the intestine can gangrene, and what would have been a minor surgery becomes a emergency major surgery where part of the bowel has to be removed.

I've referred many babies for hernia repair surgery. Groin hernias and most other hernias should be repaired. Congenital umbilical hernias often resolve by 3 years of age; those are the only ones that should be left alone for awhile. Do some research on your own and you will understand the risks.

Also, Kaiser doctors do not look at dollar signs when making recommendations. If it was only about money, they would recommend NOT treating. But it isn't about the money. It's about your health.

 

[Bamaman]

We used to have Kaiser. They were great for sniffles, but have something serious and you could be in trouble. My wife suffered with a GYN problem for years, and Kaiser never got to the root of the problem. We switched to conventional health insurance, and the problem was solved in a 30 minute procedure.

In your case, it sounds as if they're trying to push you off on Medicare in a couple of years.

Demand to see a General Surgeon and get the problem taken care of before it's a bigger problem.

 

[aldo]

I had a completely different Kaiser experience re my inguinal hernia. I noted some groin discomfort a few years ago and my GP diagnosed it as a hernia. GP asked if I wanted a referral to a surgeon, which I followed up on a few months later. Surgeon noted a small hernia, recommended open surgery, but left final decision to me. After a while (avoided it being repaired during Covid boom time), the hernia had grown in size and was becoming more uncomfortable so I decided to have it repaired. Did so successfully last week at age 67. Nothing but praise here for every one I dealt with at Kaiser

 

[GoodbyeYellow]

Bamaman: “ In your case, it sounds as if they're trying to push you off on Medicare in a couple of years.”

I’m not sure I follow this train of thought. They are encouraging me to get it done asap.

 

[GoodbyeYellow]

Most responses have been very helpful and really help allay my concerns. I do believe I will move forward.
Thank you.

 

[Irishgirlyc58]

I had Kaiser for 25 years. My experience with the drs I went to preferred to try the least invasive treatment possible - that is also my preference.
If least invasive didn’t work then we went to the next step.
I never once felt that I was being pushed into any treatment. Although after several years of trying to get my cholesterol down without medication my doctor told me that it was making him nervous. So now I take medication for my cholesterol.

I will say that I think what treatment is offered to you can be dependent on your doctor-PCP. I think this is true no matter the organization.

If you decide to have the surgery I hope it goes well for you.

 

[pacergal]

Even babies, especially preemies, can have hernias. Girls can have hernias. Hernias in the groin area (the most common place) are at significant risk of complications and should be repaired. Most hernias are not painful most of the time. but if bowel gets into the hernia and gets trapped, not only is it painful, the portion of the intestine can gangrene, and what would have been a minor surgery becomes a emergency major surgery where part of the bowel has to be removed.

I've referred many babies for hernia repair surgery. Groin hernias and most other hernias should be repaired. Congenital umbilical hernias often resolve by 3 years of age; those are the only ones that should be left alone for awhile. Do some research on your own and you will understand the risks.

Also, Kaiser doctors do not look at dollar signs when making recommendations. If it was only about money, they would recommend NOT treating. But it isn't about the money. It's about your health.

I had Kaiser for 25 years. My experience with the drs I went to preferred to try the least invasive treatment possible - that is also my preference.
If least invasive didn’t work then we went to the next step.
I never once felt that I was being pushed into any treatment. Although after several years of trying to get my cholesterol down without medication my doctor told me that it was making him nervous. So now I take medication for my cholesterol.

I will say that I think what treatment is offered to you can be dependent on your doctor-PCP. I think this is true no matter the organization.

If you decide to have the surgery I hope it goes well for you.

++
We switched to Kaiser a few years ago, and I am very pleased with the care we have received.

You don't want to risk a gangrenous bowel requiring emergency hernia repair. Do it now when it is a much simpler surgery.

 

[CindyBlue]

I've had Kaiser for most of my life, with a few years off due to work health care being free and Kaiser costing me out of pocket, so I switched. Glad I switched back, even though it cost me.

One of the many things I like about Kaiser is that they have a lot of doctors on staff, so if I'm not comfortable with one doctor's opinion/actions, I can just ask for a second - or even third etc. - opinion, and get a lot of choices. I personally like their cautious approach, and it has so far served me very well.

My parents both got exceptional care from Kaiser, throughout their lives, especially as they declined and then passed.

I'd get another opinion and then go with your gut - oops, no pun intended (grin!)