Tummy tuck for the holidays? Many try to squeeze in elective surgeries at year’s end

Dec. 20--People aren't just shopping for toys, clothes and other gifts this time of year.

They're also buying new knees, getting breast augmentations and scheduling colonoscopies.

Each year, elective surgeries spike around the holidays in Chicago and across the nation. Many patients wait to schedule surgeries until after they've hit their health insurance deductibles toward the end of the year so they don't have to pay as much out of pocket for procedures. It's a trend that shows no signs of slowing, especially as an increasing number of people enroll in high-deductible insurance plans.

Last year, more than 43 percent of adults ages 18 to 64 who get health insurance through their employers were enrolled in plans with deductibles of at least $1,300 per individual or $2,600 per family, according to the Centers for Disease Control and Prevention. That was up from about 15 percent of adults enrolled in similar plans in 2007.

"I have patients calling and basically begging to get in before the end of the year, and we're trying to fit them in wherever we can," said Dr. Jeffrey Nathanson, a gastroenterologist at NorthShore University HealthSystem. "A lot of people want to make sure they've met their annual deductible before having anything elective."

Among the procedures that see increases this time of year are bunion surgery, breast lifts, vasectomies, tummy tucks, carpal tunnel surgery and gastric bypasses, according to Amino, a digital health company that offers data about health care costs and quality.

Carina Lupisan, of Rogers Park, had a cyst behind her knee removed and a torn meniscus repaired earlier this month at Weiss Memorial Hospital in Chicago. She wanted to get it done sooner rather than later, feeling her knee getting progressively weaker as she walked.

It was a bonus, she said, that she didn't have to pay out of pocket for the procedures because she had already met her deductible and $3,000 out-of-pocket maximum for the year.

"That's a lot of money for a lot of people," said Lupisan, 55.

Podiatry services, knee replacements and hernia repairs are also common toward the end of the year, said Dr. Shesh Rao, chief medical officer at Amita Health Saint Joseph Hospital Chicago.

"Most patients are fully aware of their deductible ... and what their out-of-pocket expense is, so they're very mindful of that," Rao said.

Rush University Medical Center sees about a 5 to 9 percent increase in surgeries between about Thanksgiving and Christmas, said Murray Fields, associate vice president of perioperative and interventional services. He said patients often try to squeeze in knee replacements, sinus surgeries and plastic surgeries.

Colonoscopies are also popular toward the end of the year, though that may be partly because not all patients understand that colonoscopies done for screening purposes generally must be fully paid for by insurance regardless of when they're done, under the Affordable Care Act, Nathanson said. Colonoscopies performed because a person is experiencing symptoms may cost a patient cash out of pocket.

Deductibles, however, aren't the only reason many patients wait until the holidays to go under the knife. Some patients schedule them so they don't have to take off extra time from work to recover, doctors say.

Others sign up for cosmetic procedures in November and December in hopes of turning heads at holiday parties or starting the new year with a new look. Cosmetic procedures aren't typically covered by insurance.

Sandra Harris, of Crete, has had a number of cosmetic procedures over the years -- and she always tries to squeeze them in at the end of the year. Last year and this year, she had liposuction.

"It's easier for me to be able to stay home to recover during that time," said Harris, 46. "Also, going into the new year, I want a fresh look."

Harris' doctor, Dr. Gregory Wiener with The Art of Plastic Surgery near O'Hare International Airport, said it's something he often hears from patients this time of year. He said procedures generally pick up right before Thanksgiving and stay up nearly until Christmas. A lot of his patients want Botox, Juvederm and light chemical peels this time of year, he said. He's also recently done breast augmentations, liposuctions, tummy tucks and transfers of fat to the buttocks.

The increase can mean long hours for Wiener in November and December, as well as for surgeons at many other area clinics and hospitals.

Rao, with Saint Joseph Hospital, said surgeons there often postpone their vacations until January.

It's a similar situation at Rush, Fields said.

"We're kind of like UPS," Fields said. "It's pretty tough to get a vacation before the holidays."

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