IT STARTED WITH A WOW…!

IT STARTED WITH A WOW...!

My Why Story for Starting Simply Smart Health

Have you or a loved one, ever been faced with a catastrophic medical diagnosis or complex medical condition?

If the answer is no, then thank god and be blessed.  If the answer is yes, then the story of why I started Simply Smart Health will probably hit close to home for you.

 

In early 2015, my wife began to experience severe headaches and a fullness feeling in the back of her head.  Initially, we just wrote these off as migraines, and in true husband / physician fashion, I told her to just suck it up and get back to work.

 

However, her symptoms continued to persist, expand in intensity and frequency, and then I received a phone call.  She was driving our daughter to school one morning and suddenly lost most of her peripheral vision.  She was able to pull off to the side of the road safely, but something was most definitely wrong.  I picked her up immediately and we went straight to the outpatient imaging center, where I ordered an MRI of the brain with and without contrast.

 

The center was very busy, but they were able to work her in for the non-contrast view but advised that they would have to bring her back the next day for the contrast study.  I was very grateful that we were able to get this done immediately, even if we had to come back the next day for the second part of the test.  My wife went back for the MRI while I waited in the waiting room.  After about thirty minutes, the imaging center owner came out and sat down to chat with me.  I have known him for many years.  He struck up a general conversation and let me know that they were going to just go ahead and do the contrast study today as well.  I had a feeling that something was wrong because they were now staying late to get the entire MRI of her brain completed, I asked, “you guys saw something on the non-contrast MRI study, huh?”  His answer was YES.

I had a feeling that something was wrong… I asked, “you guys saw something on the non-contrast MRI study, huh?” His answer was YES.

As the word YES came off his tongue, I felt an immediate wave of heaviness that overtook me.  It started from the top of my head and traveled all the way down to my feet.  I remember thinking, “this cannot be happening.”  I held my composure and waited for my beautiful wife to come out to the waiting room.  When I saw her face, I knew she had no idea what was going on, nor did she know that I had any more information than she.  What was I going to tell her?  We asked for a copy of the studies on a CD, and we left the imaging center.

 

I immediately called a neurology friend of mine, who met us in the doctor’s lounge at the hospital.  He sat down at the computer, with my wife and I standing behind him, and inserted the CD.  I am not a neurologist, but as soon as the images came up on the screen, I saw a large mass in the posterior aspect of her brain, specifically in the cerebellum.

 

I said “UMM,” my wife said “WHAT,” and our neurology friend said, “WOW…!”  This is where my wife slapped him and said, “DON’T SAY WOW…!”  He forgot that the patient was standing right behind him.  After we all regained our composure, we discussed what he saw.  It appeared most likely to be a cerebellar hemangioblastoma.  It was a brain tumor, and we needed a neurosurgeon.

I said “Umm,” my wife said “What,” and our neurology friend said, “WOW…!” …my wife slapped him and said, “DON’T SAY WOW…!”

We spent the next week, in between multiple bouts of crying and tons of Rolaids, scouring the internet to find the best neurosurgeon in the country with the most experience in cerebellar hemangioblastomas.  As a physician, I was able to immediately directly connect on the phone with some of the top neurosurgeons:  Cornell – New York, University of Florida – Gainesville, MD Anderson.  We had compiled a list of very detailed questions to flush out who had the most experience and best outcomes.  We eventually found the most experienced surgeon close to home, right here in Tampa.  While most of the other surgeons I interviewed had only done a handful of these specific tumors in their entire career, this Rockstar had done over ten per year for over ten years.  My wife loved him too, and we knew we had found our guy.

As a physician, I was able to immediately directly connect on the phone with some of the top neurosurgeons in the country.

Within less than a week, we had coordinated all the plans.  I took on the burden of making sure all the insurance financial issues were proactively addressed, and the day of surgery was upon us.  As they wheeled her away from the pre-op area to the operating room, we gave each other the most loving kiss, and she asked that no matter what happened, I needed to make sure that I raise our daughter to be a loving, caring woman.  This is not what I wanted to hear.

 

The family all gathered in the surgical waiting area, for a procedure that was anticipated to last over five-hours.  The stress of the situation finally overtook me, and tears streamed down my face.  For the first time in both of our lives, my nineteen-year old daughter held and comforted ME.  When the surgeon appeared in the waiting room after only three-hours, we all stared at him in utter silence and fear, “What happened” I asked.  He suddenly realized that his premature unexpected presence startled all of us into thinking that something went wrong, but he quickly corrected this with a smile and reassurance that that the procedure went much better than expected, and that she had done GREAT…!  The tumor was benign and was fully resected that day.  Her recovery was long, but uneventful.   Other than periodic headaches, my wife is cured and fully regained her vision.

Then came the unexpected… A surprise medical bill for $30,000.

Then came the unexpected… A surprise medical bill for $30,000.  I thought I was very savvy and had everything handled ahead of time.  I was wrong.  We spent the next three months trying to negotiate this charge to a reasonable level, and came up with our mantra of: WWMP (“What Would Medicare Pay”) as our benchmark to determine what would be a ballpark fair rate.  Eventually we were able to settle on a rate that was 150% of Medicare, but it took tremendous time, knowledge, and effort to make that happen.

 

Finally, we were relieved to be past the stress of the tumor, and to have put the surprise medical bill behind us.  Uh oh… there was more.  Eight months later, the icing on the cake was a premium increase of 32% from our insurance carrier.  I had enough.

 

You may ask, “how is this My Why Story for Starting Simply Smart Health?”  My wife’s medical experience seemed to go smoothly.  The surprise bill and premium increase arguably could cause frustration, but not necessarily trigger a new purpose in life.  Although the financial issues were a major contributing factor, as I reflected on the underlying experience that we went through, I realize that there was a huge problem with the way healthcare operates:

  • How would this have gone if I were not a doctor?
  • What support do people really have in navigating this chaos?
  • Why should the patient and the family be the ones responsible for coordinating all these things on their own, while simultaneously dealing with what was perceived as a catastrophic health issue?
  • Why isn’t there someone that can take on this burden for them?

I then decided that there needed to be a better way.

I created Simply Smart Health to create a new approach to healthcare, one that delivers an exceptional VIP-type experience with fair, transparent pricing.

Simply Smart Health is delivered as a premium employee healthcare benefit solution for employers, that helps them appreciate an EASY WIN for significant cost reduction that flows right to the bottom line.

With Simply Smart Health, employers no longer have to choose between lowering costs and delivering exceptional employee healthcare benefits.

Author
Jerry Beinhauer MD
CEO at Simply Smart Health

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