Arnon Krongrad M.D.

Scrub, Rinse, Repeat

America Needs a Penile Implant Surgery Market

Let's start delivering quality, convenience, and cost transparency.

Posted Mar 03, 2016

How would you feel if first you had prostate cancer, treated it with surgery, and lost your erections?  Common treatments like Viagra do not help you.  You do your research and learn of an outpatient procedure that could restore your erections.  Then, you learn your insurance will not pay for it.   You contact your local hospital who has the treatment available, but can’t tell you how much it costs, who the surgeon is and what happens in the event of complications. Are you now part of the majority that has given up on healthcare?

If you are David Knight, of Knoxville, Tennessee, you would feel frustration and the determination to gain simple access to an inflatable penile prosthesis, a device with a 40-year history that restores erections in cancer patients like him and many others.

David, not his real name, had health insurance, a PPO plan with a very large carrier. This was irrelevant because his plan did not cover penile implant surgery. Surprised? Don’t be. Treatments for erectile dysfunction – like treatments for obesity, infertility, poor eyesight – are often not covered.

David is part of a growing consumerist segment in healthcare, a patient seeking quality, convenience, and value without a third party’s support. America has not had a consumerist healthcare economy for over 50 years and is not yet fulfilling its needs. This is changing with such innovations as direct primary care and online posting of prices. It needs to change faster.

David approached a hospital near his home, which quoted a penile implant surgery for $60,000. Did it include anesthesia? No. Did it include the prosthesis? No. Who was the surgeon? They didn’t know. David was not satisfied.

As a next step, David acted next like an increasing number of healthcare consumers who shop online, where he found Surgeo, a free market that offered access to penile implant surgery with clear cost. The market is designed and driven by surgeons and relies solely on surgeons who go through peer credentialing, which is the best way to get at surgeon quality. It offered him:

  • Comprehensive packages that included the surgeon, anesthesia, facility, choice of prosthesis, off-line call center support, and complications protection, for convenience
     
  • Clear cost that included not only the primary procedure but also such ancillary procedures as circumcision as may be needed, to eliminate financial surprises
     
  • Protection of up to $25,000 for up to one year against financial losses related to complications of penile implant surgery, such as infection
     
  • Choice of uniformly defined surgery packages and tools that made it possible to compare them side by side by surgeon, cost, and location, for even more convenience

Given that every surgeon in the market had been peer credentialed, David believed he would get quality with any of them. For example, the surgeons who lead the penile implant surgery packages in Nashville, Tennessee and Birmingham, Alabama have each done thousands of cases, published original research, and taught other surgeons. He trusted all of the choices he saw.

David next turned to cost and location to help him choose. He found easily discernable cost differences, ranging from $19,400 in Florida to $26,700 in New York. He chose neither, preferring a Nashville package for $24,900.  Why? Because it was close to home.

A different post-prostatectomy patient, who lives in Pigeon Forge, Tennessee and whose insurance also did not cover penile implant surgery, chose the lowest cost package in Florida. This is the point: health care is intensely personal. To simplify access and satisfy consumers, choice is important and personal. The more choice we offer, the more healthcare we will deliver.

Erectile dysfunction is an epidemic and the provider community, ranging from diabetes educators to primary physicians to many urologists, is woefully under-educated about topics ranging from complications of surgery to the role of the partner. Coupled to shrinking coverage and nearly impenetrable service delivery, this global deficiency leaves men struggling with the effects of cancer, diabetes, obesity, hypertension, heart disease, and other maladies struggling. A penile implant surgery market with that offers simple access, clear costs, and choice can help them.

Nebraska’s governor, looking for ways to cut spending on Viagra, once declared that sex is not medically necessary. Some would dispute this position. None would dispute that patients need quality, convenience, and choice. Whether for urological, orthopedic, bariatric, or any other surgery, David’s story illustrates that we can simplify access to surgery with qualified surgeons, comprehensive service, clear cost, and plenty of choice. America’s consumerist future means that we will.