ORA: 11092015-IRB01 Date IRB Approved: 10/21/2011 Expiration Date: 10/21/2012 Amendment Date: 11/16/2011
Title of Study:
Patient Perception of Physician Reimbursement in Spine Surgery
What is involved in the study?
The goal of this research study is to measure the difference between what patients’ perceive the costs
of spinal surgery are and compare this to actual reimbursement. Participation in this study will involve only the
completion of the enclosed questionnaires. These questionnaires are kept anonymous. Your responses
will not be known to your doctor - you will receive the same care from your doctor whether or not you
choose to participate in the survey. We realize that you may not have any idea what doctors get paid.
Please make your best guess when answering the questions. There are no right or wrong answers!
Once you fill out the survey, place it in the enclosed envelope and present to the receptionist in the clinic. This
indicates your willingness to participate in this study. There will be no requirements for you
beyond the completion of the questionnaire.
Research studies include only people who choose to take part. Remember that your participation is
completely voluntary. There is no penalty if you decide not to take part in this study or decide later that
you want to stop participating in this survey. Your care at Rush University Medical Center will not be
affected if you decide not to participate.
What will you be asked to do?
Subjects, who are considering spine surgery or visiting their surgeon after their surgery at Rush
University Medical Center, will be presented with this letter and survey at their initial check-in to the
clinic located at Midwest Orthopaedics at Rush University Medical Center. You can consent to be part
of this study by completing the attached questionnaires. We expect these surveys to take about 15
minutes to fill out. The combined data from these surveys may be published or presnted at scientific meetings.
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ORA: 11092015-IRB01 Date IRB Approved: 10/21/2011 Expiration Date: 10/21/2012 Amendment Date: 11/16/2011
Surgical Reimbursement Patient Survey
1. What is Your Age? ________years
2. What is your gender? (Check One)
Male
Female
3. Have you ever had lumbar (low back) spine surgery? (Check One)
Yes
No If NO, skip to question 5.
4. Are you satisfied with the outcome of your low back surgery? (Check One)
And what was the procedure? (Discectomy, Laminectomy, Fusion)
Yes
No
5. Have you ever had cervical (neck) spine surgery? (Check One)
Yes
No If NO, skip to question 7.
6. Are you happy with the outcome of your neck surgery? (Check One)
And what was the procedure? (Laminectomy, Fusion Front, Fusion back)
Yes
No
7. What is the highest level of school you completed? (Check One)
Did Not Graduate High School
Bachelors or other Undergraduate College Degree
High School or High School Equivalent (GED)
Any Graduate Degree
College or University
I Prefer Not To Answer
8. What was your approximate household income last year? (Check One)
Less than $20,000 / Year
$75,000 - $150,000 / Year
Greater than $250,000 / Year
$20,000 - $ 75,000 / Year
$150,000 - $250,000 / Year
I Prefer Not To Answer
9. What Is Your Primary Health Insurance? (Check One)
Medicare
Medicaid
HMO
PPO
None
I Don’t Know
Worker’s Compensation
10. What do you think is a reasonable fee that an orthopaedic surgeon should receive to perform a lumbar
(low back) discectomy (removing a herniated disc in the low back)?
The surgery involves a 1-2 inch incision to expose the spine. The nerves in your spine are identified and
gently moved out of the way. The loose piece of disc that is pushing on the nerves is removed to free up
the nerve. The procedure usually involves the use of a microscope and typically takes 1 to 2 hours.
Complications include the risk of nerve injury and leakage of spinal fluid. This procedure is typically
performed on an outpatient basis.
(The fee includes the operation itself, the time your surgeon spends with you in the hospital, and his or her care for you
for 90 days after surgery. The fee DOES NOT include preoperative evaluation or the fee the hospital gets paid.)
Please write the amount here $ _______________
11. How much do you estimate that Medicare actually pays for this procedure and aftercare (90 days)?
Please write the amount here $ _______________
12. What do you think is a reasonable fee that an orthopaedic surgeon should receive to perform a single
level posterior lumbar spine decompression and fusion?
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ORA: 11092015-IRB01 Date IRB Approved: 10/21/2011 Expiration Date: 10/21/2012 Amendment Date: 11/16/2011
The surgery involves a 4-6 inch incision to expose the spine in the low back. Bone spurs and bulging discs
compressing the spinal cord are removed. The spine is fused at that level with screws, rods and bone graft
to prevent instability. The procedure typically takes 2-4 hours and requires a 2-3 day hospitalization.
Complications include the risk of nerve injury, leakage of spinal fluid, bleeding and infection.
(The fee includes the operation itself, the time your surgeon spends with you in the hospital, and his or her care for you
for 90 days after surgery. The fee DOES NOT include preoperative evaluation or the fee the hospital gets paid.)
Please write the amount here $ _______________
13. How much do you estimate that Medicare actually pays for this procedure and aftercare (90 days)?
Please write the amount here $ _______________
14. What do you think is a reasonable fee that an orthopaedic surgeon should receive to perform a single
level anterior cervical discectomy and fusion?
The surgery involves a 3-4 inch incision to expose the anterior spine in the neck. Dissection must be done
very carefully in the neck between the trachea, esophagus and important vessels to expose the cervical spine.
Bone spurs and herniated disc compressing the spinal cord are removed. The spine is fused at that level with
a plate, screws and bone graft to prevent instability. The procedure typically takes 1-3 hours and requires an
overnight hospitalization. Complications include the risk of nerve injury, leakage of spinal fluid, bleeding,
infection and difficulty swallowing.
(The fee includes the operation itself, the time your surgeon spends with you in the hospital, and his or her care for you
for 90 days after surgery. The fee DOES NOT include preoperative evaluation or the fee the hospital gets paid.)
Please write the amount here $ _______________
15. How much do you estimate that Medicare actually pays for this procedure and aftercare (90 days)?
Please write the amount here $ _______________
16. What do you think is a reasonable fee that an orthopaedic surgeon should receive to perform a mutli-level
correction and fusion of a scoliotic or curved spine?
The surgery involves a 12-18 inch incision to expose the entire spine in the mid and low back. The curved
spine is corrected by placing screws at many levels in the spine with long rods used to straighten the
curvature, as well as fusing the spine with bone graft. The procedure takes several hours and many days in
the hospital are required for recovery. Complications are more common and include the risk of nerve injury,
leakage of spinal fluid, bleeding and infection.
(The fee includes the operation itself, the time your surgeon spends with you in the hospital, and his or her care for you
for 90 days after surgery. The fee DOES NOT include preoperative evaluation or the fee the hospital gets paid.)
Please write the amount here $ _______________
17. How much do you estimate that Medicare actually pays for this procedure and aftercare (90 days)?
Please write the amount here $ _______________
18. Do you think your surgeon should get paid more for doing a minimally invasive procedure? A
minimally invasive surgery involves performing similar procedures to those described above using smaller
incisions and specialized tubes to access the spine with specialized instruments and implants in order to
make recovery from surgery quicker and easier. If so, how much more should the surgeon be paid :
No, they should be paid less
20% more
50-100% more
0%, should be paid the same
20-50% more
Greater than 100% more
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ORA: 11092015-IRB01 Date IRB Approved: 10/21/2011 Expiration Date: 10/21/2012 Amendment Date: 11/16/2011
19. How much do you think a spine surgeon should earn each year? Training consists of 4 years of
undergraduate education, 4 years of medical school, at least 5 years of an orthopedic or neurosurgical
residency and an additional year of sub-specialty training in spine surgery (Approximately 10 years of postcollege training).
Please write the amount here $ _______________
20. On average, Medicare pays an orthopaedic surgeon about $971 for performing a lumbar discectomy
(removing a herniated disc in the low back, usually a 1 to 2 hour procedure). Please indicate your feeling
about this fee (check one)
$971 is much lower than what a surgeon should earn for this procedure.
$971 is somewhat lower than what a surgeon should earn for this procedure.
$971 is about right for what a surgeon should earn for this procedure.
$971 is somewhat higher than what a surgeon should earn for this procedure.
$971 is much higher than what a surgeon should earn for this procedure.
21. On average, Medicare pays an orthopaedic surgeon about $2,413 for performing a single level posterior
lumbar spine decompression and fusion (removing bone spurs and bulging discs compressing the spinal
cord in the low back, and fusing that level with screws, rods and bone graft to prevent instability, usually a
2-4 hour procedure). Please indicate your feeling about this fee (check one)
$2,413 is much lower than what a surgeon should earn for this procedure.
$2,413 is somewhat lower than what a surgeon should earn for this procedure.
$2,413 is about right for what a surgeon should earn for this procedure.
$2,413 is somewhat higher than what a surgeon should earn for this procedure.
$2,413 is much higher than what a surgeon should earn for this procedure.
22. On Average, Medicare pays an orthopaedic surgeon about $2,158 for performing a single level anterior
cervical discectomy and fusion(removing bone spurs and herniated disc compressing the spinal cord in the
neck, and fusing that level with a plate, screws and bone graft to prevent instability, usually a 2 hr
procedure). Please indicate your feeling about this fee (check one)
$2,158 is much lower than what a surgeon should earn for this procedure.
$2,158 is somewhat lower than what a surgeon should earn for this procedure.
$2,158 is about right for what a surgeon should earn for this procedure.
$2,158 is somewhat higher than what a surgeon should earn for this procedure.
$2,158 is much higher than what a surgeon should earn for this procedure.
23. Have you read any recent newspaper articles regarding payments for and appropriateness of spinal
surgery, and if so have these negatively affected your opinion of spinal surgeons? Yes
No
Please feel free to comment on this and offer any additional comments below:
Thank you for your time. Please return the survey in the envelop provided and seal the envelope
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