Doctors Stop Circumcisions After Finding Out What They Cost

Patients have a difficult time finding how much hospitals charge for procedures. Doctors can have the same problem. Two doctor practices in Anchorage, Alaska, stopped performing circumcisions in a local hospital when they found out what the hospital was charging for the procedure; they decided to take a stand against prices they felt were too high.

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MELISSA BLOCK, HOST:

One of the issues that often comes up when we're discussing health care is how hard it is for anyone to know exactly how much any one medical procedure costs. It turns out doctors are often in the dark as well when it comes to knowing what hospitals charge. Well, when two groups of Alaska pediatricians discovered how much a regional hospital was charging for circumcisions, they decided to take a stand.

Alaska Public Radio Network's Annie Feidt reports.

ANNIE FEIDT, BYLINE: In a small room at the offices of Anchorage Pediatric Group, Dr. Charles Ryan is getting ready to circumcise a 12-day-old baby. Ryan numbs the area with anesthetic.

(SOUNDBITE OF CRYING INFANT)

CHARLES RYAN: Now we got him pretty mad. But he's not in any pain. So there you go. There. Was that the worse thing that's ever happened, huh?

FEIDT: Ryan is doing more circumcisions in the office instead of the hospital these days. About a year ago, he found out Alaska Regional Hospital is charging $2,110 for the procedure. That's almost 10 times more than Providence Hospital, a few miles away, which charges $235. So the doctors in Ryan's office decided to stop doing circumcisions at Regional.

RYAN: There was no long discussion.

FEIDT: Like how much discussion did it take?

RYAN: Oh, two minutes. It wasn't much. We were, I think, shocked by the price that we were hearing.

FEIDT: For that $2,110, the hospital is providing a small tray of sterilized and reusable instruments, a nurse to help out and a place for the infant to lie down. Ryan charges $700 for circumcisions in the hospital or in the office. He calls Regional's facility fee wildly abnormal.

RYAN: Health care dollars are limited and we'd like to see them spent in ways that really provide good health care for people and necessary health care for people. And when the health care dollar is being milked off by charges that just seem out of proportion to what the cost of delivering those services is, then those are dollars that can't be used for more essential things.

FEIDT: Another large pediatric practice felt the same way and has stopped doing most of its circumcisions at Regional, too. Regional Hospital declined to go on tape for this story. In an email, a hospital spokesperson says the cost is so high in part because the hospital has to be ready to treat minor and major medical emergencies.

She also points out insurance companies negotiate better rates and the average amount the hospital collects for circumcisions is $340. Dr. Jack Percelay chairs the American Academy of Pediatrics' Committee on Hospital Care. He says the fee is an example of how hard it is to find out how much hospital care costs. He says doctors are speaking up when they think a hospital is charging too much, although most talk to hospital administrators behind closed doors.

JACK PERCELAY: I'm sure there are many private discussions in terms of setting what seems to be, you know, reasonable fees. I have not heard of people boycotting the services at one hospital based on charges previously.

FEIDT: Percelay says more and more doctors are becoming aware of costs. Dr. Charles Ryan at Anchorage Pediatric Group says the incident has convinced him he needs to at least try to be better informed on hospital prices for all kinds of procedures.

RYAN: Neither hospital is out there trying to put that information right in front of us and sometimes it's hard information to get if you ask.

FEIDT: Ryan emphasizes he thinks Alaska Regional is a good hospital and he says health care costs in the U.S. don't always seem rational, but he hopes administrators at Regional will consider making this one charge at least a little more reasonable. For NPR News, I'm Annie Feidt in Anchorage.

BLOCK: This story is part of a collaboration with NPR, Alaska Public Radio Network and Kaiser Health News.

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