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Shopping For Surgery Online

Would you shop online to find the best deal for a tummy tuck or a nose job? If you needed a heart operation or brain surgery, would you search the Internet to see what kind of bids doctors are offering?

While some doctors and patients raise ethical questions about the idea, a handful of companies are setting up shop online to let consumers compare physicians' bids for their business.

Consumers can log on, enter their medical profile and specify the surgical procedure they want. The online services then match the requests with participating doctors, who submit proposals, including cost, for the patient's review.

Some sites match bids only for elective surgeries. But Wisconsin-based PatientWise will accept requests for nearly 100 procedures, including hip replacement, heart surgery and brain surgery, chairman Bradley Engel said.

Although PatientWise's online site is up, the company won't be ready to serve customers until later this year, Engel said.

Medicine Online Inc. of San Diego launched its site in March, offering 36 procedures including breast augmentation, nose jobs, liposuction, dental surgeries and laser corrective eye surgery. The company has had 300 consumers bid for transactions and 170 doctors have registered online, said Chief Operating Officer Michael Sussman.

"We feel we’re educating and empowering the consumer to make better informed decisions,“ said Sussman. ”We are legal, we are ethical, we are moral. Doctors advertise now without meeting patients, in print, on billboards, on radio and TV. And they don’t offer their qualifications at the time they advertise."

Dawn Buchanan shopped Medicine Online when she was contemplating cosmetic eye surgery.

Buchanan, 43, of Orange County, Calif., got five bids from different surgeons, ranging from $1,500 to $3,000, to remove bags under her eyes and tighten her brows.

“It's the wave of the future,” said Buchanan, who had surgery Monday. “It was like shopping for a car but I didn't have to leave the house.”

But Louise Herman, a lawyer in Montclair, N.J. who recently had corrective eye surgery, would never have gone online to find a doctor to perform the procedure.

"It's like looking in the yellow pages. I would be patently suspicious of a medical professional who advertises," says Herman. "The way I look for a doctor is word of mouth, people that I trust; other medical professionals would be a source that I’d use. And then, in a personal interview, because I could assess their credentials, their experience, and also get a sense as to whether I was comfortable working with the doctor… You want somebody with a good bedside manner, who will give you the time and the attention you’re looking for.”

The medical establishment has given online doctor-patient matchmaking a cool reception.

“It is irresponsiblfor surgeons to even discuss the cost before seeing the patient,” said Dr. Joseph J. Fins, director of medical ethics at New York Presbyterian Hospital-Weill Cornell Medical Center.

Dr. Michelle Copeland, a plastic surgeon with Mt. Sinai in New York, agreed.

”It can be misleading to the public. While we all should be cost-conscious, the public and patients need to know that when they’re selecting their surgeon, it’s serious business and there’s more to it than who is willing to do it at the lowest cost," said Copeland. "You don’t want someone cutting corners when it comes to your health.”

Medicine Online said it does not encourage patients to pick doctors solely on price, while PatientWise's Engel said quality care is the company's goal, not cheap medicine.

“For some, the focus will be on price, but the objective is to give people side-by-side comparisons of statistics on quality,” Engel said.

Engel said PatientWise consumers must submit a bona fide diagnosis and treatment recommendation from a referring doctor. The company will verify all patient and doctor information.

Critics questioned the diligence of such services.

“A lot of people are influenced by price and these services do little to screen the patients or the providers,” said Dr. Michael McGuire, president of the California Society of Plastic Surgeons, which is asking the state attorney general to investigate online medical bidding.

McGuire said he joined one site as a psychiatrist and successfully bid to perform a breast implant. The site had a disclaimer saying it could not verify doctors' credentials.

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