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OSE_1309_part2_Layout 1 9/6/13 3:25 PM Page 54 2013 Awards patient that walks into a hospital is a cherry! They've seen to that. And they never want to talk about their uncompensated care payments, where they actually get paid [a percentage by the government] to the extent that they weren't paid. There are all kinds of shenanigans. They don't really provide any charitable care. They're paid even when they're not paid. They raise this charity flag with one hand while they fleece the taxpayer with the other." Moreover, the center doesn't simply turn away those of extremely limited means. Dr. Smith recounts the story of a patient who sold his pickup on the way to the center so he could pay for his wife's surgery. "We found out later, after we got started," he says. "I looked at the surgeon and said, you know, the nice thing here would be to do this for nothing. He said, 'Keith, I couldn't agree more.' So I grabbed a wad of 100-dollar bills and went up to him in the waiting room and gave him his money back. I said, 'Go back and get your truck, man.' "We're physicians. We're not mercenaries. That's one way people try to marginalize what we're doing, by characterizing us as mercenaries." Not that everyone who's a little low on cash gets a deal like that. "Our price is $3,000 for a tonsillectomy — surgeon, anesthesia and facility. Families can usually get together and handle that," says Dr. Smith. And if they can't? "It's a case-to-case basis and I make all those decisions." "We're in business like anyone else," says Mark Pascale, MD, an orthopedic surgeon who's partnered with the center for 14 years. "And we're making what we think is fair money for what we're doing. What we're not doing is charging $20,000, knowing that insurance is gonna knock 10 off it, and there's gonna be another discount for this and this. It costs us this much, we know this much is profit, and that's what we're gonna charge, and we're fine with it." The reality, insists Dr. Lantier, is that the center's approach is more 5 4 O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | S E P T E M B E R 2013