Spine Brokers: Helpful or Hurtful?

[jamie5136]

First, let’s look at what a spine broker does? Typically they work on behalf of or for a specific doctor(s) and get paid either directly by that doctor or through an associated company. Their MAIN goal is to make money for the doctor and their main interest lies with the doctor. That is how they make a living. The doctor who they are representing is number one, no matter what.

They may present themselves as an advocate for the patient, but they are really more of a facilitator/advertiser for that doctor to convince patients to travel from America to visit other doctors out of the country. Yes, American healthcare is an issue, but there is a clear reason why certain procedures are not approved and it is not always because the insurance company does not want to pay. It is many times because the device/product has not been proven to work in a specific application.

Advocates can certainly be helpful in many ways, such as getting your films to the doctor, communicating with the doctor, helping with travel arrangements and then helping transfer/wire money into their offshore accounts, which can be challenging. Many times they can help you understand the procedure in minor detail and above all tell you how great the doctor is, whether they are or not. But, please realize that they WORK FOR THE DOCTOR. They are not getting paid by you, but the doctor! They will do anything or say anything to get your business, even if it involves discussing issues beyond their realm of medical understanding or even offering up false statistics or hiding facts about failures or things that can go wrong with the surgery. You hear the good, but you rarely hear the bad. The main issue is what happens when the surgery is over? Guess what, you are on your own. So, if you have issues, the communications may cease, you may be given surgical advice that may not be to your benefit and then you are stuck with finding a doctor in America to help you, which can be a HUGE challenge. Many doctors won’t deal with failed overseas patients. So, if you insist on going overseas, find a good follow-up doctor in the states.

Everything bad that could happen with my spine broker and subsequent problems happened, and now I am left with, “I am not helping you anymore.” I guess I had a lot of questions after spending nearly 60k and still in pain. I am now on my own.

I encourage everyone to understand the motives of a spine broker, do your own research, read the REAL studies regarding the surgery and the REAL percentages of successes vs. failures and what happens if you need a revision. Talk to patients who have had the same surgery (after one year of healing), speak with doctors, etc. If something bad happens, as it did it my case, lumbar revision can be life threatening, yet they never do tell you this. Although, of course I was offered to come back for small fee of approximately $25,000 USD for a fusion and “If” that did not work, come back to for a dangerous anterior removal!

I now spend over 4 hours a day attempting to find a surgeon to remove one or more failed ADR’s, possibly fuse over a severely sunken disc (which research papers say does not reduce pain) that sunk up into my bones w/out any explanation. I was not explained the risks, my post x-rays were not reviewed and my subsidence was overlooked. If any of these foreign doctors were subject to American law they would certainly have a number of legal issues. They are protected in their foreign country however. One good thing about living in America is that we have recourse. You have zero recourse against a foreign doctor. Once they have your money and you fail, so long, too bad. Your life can be ruined, but they are on to their next patient. Families and lives are destroyed and some people end of killing themselves due to unresolved pain.

I am an intelligent, educated woman with great friends, family and career (which will I am sure soon be over and I will be on disability as I can’t sit/lay down and I have leg pain) and did research for several years (obviously not enough) and my spine broker made it a point to call me often and “court” me in a sense to come to this foreign country to see the “best spinal surgeon in the world” and spend quite a bit of money for a surgery with an over 90% success rate (which is a false statistic for a three level ADR). Once it went bad, I was basically ignored and only had one call for the doctor in nearly one year. Is this fair? Absolutely not. Should humans treat others like this? No. But, guess what, it happens every day. I get emails from failed ADR patients quite a bit who do not post on the boards. These stories are so sad and they break my heart.

Just do your research, and if you work with an advocate, make sure they are not tied to any one doctor so their search for you can be objective. Ask many questions, even if they seem odd. It is your body and your life.

I would not wish what happened to me on my worst enemy. My family, friends and boyfriend are devastated, as anyone would expect. I live in pain w/out explanation.

And please let me say that I am certainly not saying that these doctors are bad doctors per se or that advocates are all evil, greedy and lying individuals, but they certainly have a motivation, so just realize this. There are tons of great overseas doctors as there are USA doctors. Good and bad doctors exist everywhere, but when a foreign doctor takes your hard-earned money (I have no retirement fund anymore) not look at your post x-rays, wait until a layperson finds a major problem and then send you a large invoice to
“maybe” correct your issue and then not answer emails and communications, this should certainly discourage Americans from going overseas. ADR is not the panacea everyone thought it was. It works for many, but for many it does not. And sometimes it takes years to realize other issue exists. ADR’s can work fine for years, but then issues can happen. And then taking them out? That can kill you. I was told this doctor was one of the only one who was capable of doing this? So, unless you are a millionaire and love to travel overseas, what is one to do?

Advocates are charming, convincing and they will make you have hope that your pain will be eradicated and they will say their doctor is the best with high success rates. Remember the motive. Again, many times it is good, but many times it is not.

This is more of a public service message for people who are maybe susceptible and desperate (as I was) and do your own research and employ the help from real doctors, read real research papers and stay up with the boards. Desperate people in pain sometimes only hear the good and avoid the bad.

If I had to do it ALL over again, I would have had a fusion in the USA mixed with one ADR, not a three level ADR. I would have great follow-up and if something went wrong, it would have been fixed to the best of their ability. There are TONS of excellent USA doctors and really, in my honest opinion, there is no reason to travel overseas (of course it depends on the surgery, etc.) I would have had a spine bone density and made sure I was even a candidate for the surgery.

My plan was to become a tri-athlete and finally get a PhD, but obviously those plans have been dashed and I am out 60k. At least if a USA doctor did this, insurance would have paid and I would have been 60k richer, which certainly helps if one has to go on disability.

Thanks for reading and good luck to all!

[JEVE19]

I just read your post.
I had never heard of a spine broker.

I'm very sorry you are having such troubles.
Thank you for sharing the info.
I am contemplating Germany or US doctor.
You definitely shed a light for me to see.

Your experience might not have went well but thank you for warning the
rest of us who are thinking of walking down that same path.

I hope you find a good doctor that can work with you and
get you feeling better.

[Jack]

jamie5136,

Great post. While reading this I thought, there but for the grace of God go I. I'm not convinced yet my spine issues are over, in fact with two more diseased L spine discs that are hopefully not causing trouble right now, I know i am not.

I too was just about ready to go to Europe. Then did a little more research and in spite of the recommendations from abroad, decided I was not a good candidate for ADR at L5-S1. The hardest part of back pain is trying to make a decision on what to do while in pain.

At your young age, you do still have time to find a solution to be able to live with your spine issues or hopefully find a solution. At least by posting honestly about your condition, others can remember you and relay new info to you as it becomes available.

[jamie5136]

If you are getting an ADR, there are so many good doctors in the USA. My issue was that I had unexplained subsidence at multiple levels, pain, no follow-up or poor follow-up, x-rays not looked at properly and then my friendly spine broker (International healthcare liason) dumped me. So, even though German doctors may be good, if something goes wrong, well, you might not be in a good position as I am not now.

[ans]

If I had the money and there was a Maven who could take care of my formanial stenosis when it becomes unbearable despite epidural, I would go b/c this pain is like a baseball bat on the shins. No amount of Neuontin I think could control this pain. What I dislike though is that if they screw up, you're outta luck - and I've only sued on ripoff artist who lied about fixing my gf's transmission (won in small claims; never collected). Hey, this is too much boring information!

[CG Brady]

It is quite telling that there is no credible data of surgery and outcomes. Doctors lie like hell. I have written a book about obesity and weight loss. Bariatric surgeons lie more than used car salesmen. They tell outright lies. They will say and a particular procedure had a 1 in 1000 mortality rate and that the procedure that they do has a 1 in 200 rate when quite often the opposite is true.

Look at it like this. You are going to have some home improvements done so you interview a few contractors. You ask them for references. You may ask how many jobs they did in 2009 for example and you can check with the codes people who had the work done. You can check the better business bureau and you can talk to other clients. It's not that easy with a doctor. All you have to go by is their BS.

As a patient you are in a tough position. If you offend Dr Money Bag's ego he could really mess you up and he may mess you up because that means more treatment tests and a possible revision surgery.

If the contractor screws up along the way you can stop paying him and find a good one. If you have to sue him the courts will be fair. Good luck suing a bad doctor.

25 years ago the deal with back surgery was 1/2 the time it makes you worse and 25% no improvement and 25% of time you get better until the fusion cause other disks to fail. Doctors love to play blame the patient/victim.

If the surgeon will not give you a list of all his patients and if he plays the HIPPA privacy card leave. He can give you those records as long as the names are blacked out.

When it comes to ADR, in theory it makes more sense than a fusion but except for M-6 disk most are ball and socket and tend to rotate. If you have facet syndrome and you have an ADR you're screwed.

Alarm bells should go off when you get 3 opinions and they are all different. One may be right but there you are again rolling the dice based of guesses, ego and greed.

My hope is that someone somewhere will create regenerative medicine that can reverse osteo arthritis and repair disks. When that happen there will be a lot of back surgeon learning cosmetic surgery to line their pockets.

[ans]

Long time; I haven't been to this site.

I hope that your pain has resolved - somehow.

I saw 3 doctors in LA who told me that they wouldn't touch me (Laurssen would under an extreme condition) as my DDD/facet arthritis, etc. is so intense:

Drs. Regan, Lauryssen, and Holly (of UCLA Spine, in Santa Monica).

I have been surprised that they weren't "knife-happy".

My very best - ans

[Tierney]

Jamie, it breaks my heart to reread your story, but I wanted you to know that it helped me find a doctor here in the States to help with my L5/S1 problem. I too talked to healthbase, was convinced ,and was ready to jump on a plane to India. At that point in my life I was in so much pain that I could no longer walk and would have done anything to stop it. Thank God and the members off this board that i found Dr. Masante of Triangle Ortho in Raleigh, NC. I had sent off an MRI cd to healthbase and the strange thing that occurred to me was that it seems like they ask you what you want done , rather than tell you what you need done.

In other words, as long as you have the money, you are automatically a good candidate for whatever surgery you want done. That's a little scary, no that's alot scary. If I had gone along with the car salesman like tactics they practice, I probably would have had a lot more surgery(harm) done than I had. What happened to "First do no harm"? Any how, I just wanted you to know that your comments helped wake me up, and find a doctor here to help me. Thanks, Tierney