Hey all,

If you're familiar with Fill Centers USA, I'd like your feedback regarding their fill policy. They say if you get an overfill, you can come back within 72 hours and get it emptied at no additional charge. However, for underfills, there is no protection and you're charged an additional 165.00!! This doesn't seem fair. My doctor (the only Fill Center doc in Utah) is conservative, and I got a fill yesterday and I'm still feeling no restriction. Any comments or suggestions?

Also, when I signed up for their services a couple of years ago, they promised me 150.00 for fills. Then they upped their rate despite their statement that fills would always be 150.00. This also seems shady to me. But they stood their ground.

I dont know their policies and i dont use them (My doc does my fills) But it woudl be nearly impossible for ANYONE to promise a free fill " after so many hours if it did not work . how would they make their money?

First off Fills can take up to 2 weeks to kick in . So what are they suppose to do say " Ok if your fill does not kick in after 2 weeks you get another one for free ? " how would they make any money ? that's the whole point of fill centers ?

Honestly be lucky they offer free unfills after 72 hours if yoru too tight. THAT is nice ! If i need an unfill even a slight one I have to pay another $125. I dont mind though my doc is my doc and he has to make a living and make money . I do not think its unfair for them to charge you again for a fill.

There is NO WAY after 24 hours you can know if your fill has kicked in . My fills do not kick in for 4-7 days typically .

HTH

Mindy

I dont know their policies and i dont use them (My doc does my fills) But it woudl be nearly impossible for ANYONE to promise a free fill " after so many hours if it did not work . how would they make their money?

First off Fills can take up to 2 weeks to kick in . So what are they suppose to do say " Ok if your fill does not kick in after 2 weeks you get another one for free ? " how would they make any money ? that's the whole point of fill centers ?

Honestly be lucky they offer free unfills after 72 hours if yoru too tight. THAT is nice ! If i need an unfill even a slight one I have to pay another $125. I dont mind though my doc is my doc and he has to make a living and make money . I do not think its unfair for them to charge you again for a fill.

There is NO WAY after 24 hours you can know if your fill has kicked in . My fills do not kick in for 4-7 days typically .

HTH

Mindy

Mindy,

First of all, I think it's rape to charge anywhere near 100.00 bucks or more for 5-10 mins. work. There may be a few exceptions, but my fills have never exceeded 10 mins. I don't care what the doctor is doing. Fills are a ripoff to begin with, especially in the US. Doctors in the US who charge this amount or more do so because they can, not because they've earned it. They know that patients need multiple fills, and many patients can't get back to their doctors in other countries. They also realize that there aren't a lot of doctors filling patients from other countries. So they take advantage of that. They're milking patients for every dime. I've seen specialists for hour long visits and have never been charged 165.00. If specialists don't make that in an hour, how do doctors justify charging it for 5-10 mins. work? Especially since the majority of fills are uncomplicated? If a fill doesn't go well, fine, attach a 10.00 fee or something. 165.00 is exhorbitant. Furthermore, what's the required training for giving a fill? A few hours? A couple of days? It's not as if they've invested themselves extensively to learn how to do a fill. Many nurses do fills, so it doesn't even require an MD to do them.

Your fills may take 4-7 days. However, my fills are either working or not within 24-48 hours. This has been consistent with 8 fills. I've been told by 3 doctors that 1-2 days is usually how long it takes for patients to know whether or not the fill is correct. Furthermore, since the Fill Center has a policy of 72 hours, there must be something to that time frame, don't you think? If 4-7 days out was typical, and they wanted patients to have fills corrected accordingly, their policy would be likely to reflect that.

What doesn't make any sense at all is that they cover overfills, but not underfills. I don't see a difference. If the fill is inaccurate, it's inaccurate. Futhermore, they've never been able to justify this policy to me. If you've got a policy, be prepared to provide clients with a reasonable explanation for it.

I guess my question to you is this: since fills are always iffy, and it's difficult to tell immediately following a fill whether or not it's working (meaning within an hour or so), it's safe to say that the doctors usually guess. If they're guessing and they're wrong, why should the patient be further burdened? If both parties know that the doctor is merely estimating a fill, one or two adjustments are NOT unreasonable to expect within a reasonable time frame. I think you're right that 1-2 weeks is unreasonble, but not 72 hours. However, if it was an exact science, and the patient specifically requested 3cc's for example, then that's different. If the patient is certain that their choice for a fill is correct, and they're wrong, fine then, let them pay for the correction. I never go in for a fill requesting a specific amount. I discuss my symptoms with the doctor and he guesses. Why is it impossible to promise additional fills then? What's unreasonble? 2 additional adjustments *might* take 30 mins. total, and that's being generous. I don't think 30 mins. justifies 165.00 either.

So how would they make their money? Well, what's reasonable for 5-10 mins. work? 20? 30? 50? At least we're in a reasonable range here. If they charged 30.00 and did 6 fills an hour (which isn't untypical), that's 180.00 and hour. That's still outrageous (again, the specialists don't make that). But at 165.00 a fill, 6 fills and hour, they're making 990.00 an hour! Who makes that?? You'll never convince me that doctors are worth 990.00 an hour, I don't care what their specialty is. But 180.00 an hour isn't a bad living, most people could live comfortably on that, even today. I think it's a little ridiculous to suggest that if they weren't charging huge amount of money for fills, that they wouldn't be able to make a living.

These outrageous charges for fills are nearly exclusive to the US. It's merely another illustration of greed withing the medical community. Not all doctors are greedy, but those who are seem insatiable. When lap bands were finally approved for the US, prices skyrocketed (for the surgery, not the hospital costs, which were added on top of that). Today, they've more than doubled what is charged in other countries. Is that reasonable? Are surgeons who have performed a procedure 500 times worth twice as much as surgeons who have performed the procedure thousands of times? I don't think so.

So no, I'm not feeling lucky that I'm making some greedy doctor ridiculous amounts of money because he knows he has me over a barrel. In fact, as I mentioned earlier, it feels like financial rape. That's not a good feeling. Ever.

Anyone have thoughts on this?

Edited January 4, 200917 yr by delrio

I thought my fill was too small also.. I think you will find about 2 weeks after, it seems to tighten up... I actually thought I was going to have to have an un fill 2 weeks later! I managed through it though and found my "sweet spot".. Good luck!

I thought my fill was too small also.. I think you will find about 2 weeks after, it seems to tighten up... I actually thought I was going to have to have an un fill 2 weeks later! I managed through it though and found my "sweet spot".. Good luck!

Hi there,

Thanks for the feedback! That makes me hopeful. In the past, my fills have been pretty consistent in that if they're not working within a day or two, weeks later they're still not working. However, this may be an exception! I'll pay close attention and cross my fingers that the fill will tighten up.

I thought my fill was too small also.. I think you will find about 2 weeks after, it seems to tighten up... I actually thought I was going to have to have an un fill 2 weeks later! I managed through it though and found my "sweet spot".. Good luck!

Which goes back to what i said it can take UP TO 2 weeks for a fill to "kick" in or tighten up .

Mindy

Mindy,

First of all, I think it's rape to charge anywhere near 100.00 bucks or more for 5-10 mins. work. There may be a few exceptions, but my fills have never exceeded 10 mins. I don't care what the doctor is doing. Fills are a ripoff to begin with, especially in the US. Doctors in the US who charge this amount or more do so because they can, not because they've earned it. They know that patients need multiple fills, and many patients can't get back to their doctors in other countries. They also realize that there aren't a lot of doctors filling patients from other countries. So they take advantage of that. They're milking patients for every dime. I've seen specialists for hour long visits and have never been charged 165.00. If specialists don't make that in an hour, how do doctors justify charging it for 5-10 mins. work? Especially since the majority of fills are uncomplicated? If a fill doesn't go well, fine, attach a 10.00 fee or something. 165.00 is exhorbitant. Furthermore, what's the required training for giving a fill? A few hours? A couple of days? It's not as if they've invested themselves extensively to learn how to do a fill. Many nurses do fills, so it doesn't even require an MD to do them.

Your fills may take 4-7 days. However, my fills are either working or not within 24-48 hours. This has been consistent with 8 fills. I've been told by 3 doctors that 1-2 days is usually how long it takes for patients to know whether or not the fill is correct. Furthermore, since the Fill Center has a policy of 72 hours, there must be something to that time frame, don't you think? If 4-7 days out was typical, and they wanted patients to have fills corrected accordingly, their policy would be likely to reflect that.

What doesn't make any sense at all is that they cover overfills, but not underfills. I don't see a difference. If the fill is inaccurate, it's inaccurate. Futhermore, they've never been able to justify this policy to me. If you've got a policy, be prepared to provide clients with a reasonable explanation for it.

I guess my question to you is this: since fills are always iffy, and it's difficult to tell immediately following a fill whether or not it's working (meaning within an hour or so), it's safe to say that the doctors usually guess. If they're guessing and they're wrong, why should the patient be further burdened? If both parties know that the doctor is merely estimating a fill, one or two adjustments are NOT unreasonable to expect within a reasonable time frame. I think you're right that 1-2 weeks is unreasonble, but not 72 hours. However, if it was an exact science, and the patient specifically requested 3cc's for example, then that's different. If the patient is certain that their choice for a fill is correct, and they're wrong, fine then, let them pay for the correction. I never go in for a fill requesting a specific amount. I discuss my symptoms with the doctor and he guesses. Why is it impossible to promise additional fills then? What's unreasonble? 2 additional adjustments *might* take 30 mins. total, and that's being generous. I don't think 30 mins. justifies 165.00 either.

So how would they make their money? Well, what's reasonable for 5-10 mins. work? 20? 30? 50? At least we're in a reasonable range here. If they charged 30.00 and did 6 fills an hour (which isn't untypical), that's 180.00 and hour. That's still outrageous (again, the specialists don't make that). But at 165.00 a fill, 6 fills and hour, they're making 990.00 an hour! Who makes that?? You'll never convince me that doctors are worth 990.00 an hour, I don't care what their specialty is. But 180.00 an hour isn't a bad living, most people could live comfortably on that, even today. I think it's a little ridiculous to suggest that if they weren't charging huge amount of money for fills, that they wouldn't be able to make a living.

These outrageous charges for fills are nearly exclusive to the US. It's merely another illustration of greed withing the medical community. Not all doctors are greedy, but those who are seem insatiable. When lap bands were finally approved for the US, prices skyrocketed (for the surgery, not the hospital costs, which were added on top of that). Today, they've more than doubled what is charged in other countries. Is that reasonable? Are surgeons who have performed a procedure 500 times worth twice as much as surgeons who have performed the procedure thousands of times? I don't think so.

So no, I'm not feeling lucky that I'm making some greedy doctor ridiculous amounts of money because he knows he has me over a barrel. In fact, as I mentioned earlier, it feels like financial rape. That's not a good feeling. Ever.

Anyone have thoughts on this?

The only thing i have to say is that you sound hostile towards ME over this policy .

I pay my doctor for an office VISIT and the fill each time i get a fill. We discuss how things are going for me , what im eating ect. It takes longer than 10 minutes.

My doc has ALWAYS said and i have heard from others fills can take up to 2 weeks to either get the FULL affect or to realize they did not work .

I am not trying to be rude but If you did not like the policy before hand then why go to them ?

each person is different when it comes to the band. I dont see how they could possibly set a policy for the band fill or unfill for that matter, ( which is what i meant its lucky they dont charge for unfills ) for people when it comes to fills.

Fill centers , in my opinion make money from people who were banded else were and either did not set up after care else where before hand or need after care.

Are they taking advantage ? Probably .

However most people i know hwo are self pay pay around $100-$150 per fill . Is it right ? I dunno . I do know the docs make more money from the surgeries than they do the fills.

As for your question , I have NEVER EVER had a fill that I have known with in an hour if it will work for me or not . One way or another , if it was going ot be too tight or not . NEVER has that happened to me. I have had fills tighten up on me as long as a month out . Is it safe to say docs usually guess ? to a certain extent yes.

my doc would laugh at me if i walked in there and said " HEY give me such and such amount of a fill " He would look at me like im nuts . It all comes back to if you did not like fill centers policies then maybe you should not have gone to them ?

that's my input

Mindy

well I have to admit I often feel they are just bleeding money from us on fills and this is why.If fills are included in the price of banding I have noticed they get bigger fills and find their level of restriction sooner than those of us that pay for fills.

Then there is the the odd thing of losing a 1/2 cc of fill ever time from the last fill so even though they say they gave you 1cc it only raised you .5 because they say you lost that .5 but yet they are not concerned about it as it is normal?Then you have to wonder are they bleeding by giving you only .5 or are they being cautious?And why the tale of the lose of .5 cc is it to keep you happy thinking yo got 1cc when you really only got .5? Who knows but we have to trust them to take care of us so they do have us over a barrel in ever since of the word.

I pay $75.00 for an office visit and then another $75.00 if I get a fill,I do see the NUT.

well I have to admit I often feel they are just bleeding money from us on fills and this is why.If fills are included in the price of banding I have noticed they get bigger fills and find their level of restriction sooner than those of us that pay for fills.

Then there is the the odd thing of losing a 1/2 cc of fill ever time from the last fill so even though they say they gave you 1cc it only raised you .5 because they say you lost that .5 but yet they are not concerned about it as it is normal?Then you have to wonder are they bleeding by giving you only .5 or are they being cautious?And why the tale of the lose of .5 cc is it to keep you happy thinking yo got 1cc when you really only got .5? Who knows but we have to trust them to take care of us so they do have us over a barrel in ever since of the word.

I pay $75.00 for an office visit and then another $75.00 if I get a fill,I do see the NUT.

Did i read this right ... they tell you you have lost .5c''s EVERY Time you get a fill ? If that's the case something is wrong and you might have a leak ! you should not be losing ANY Fluid every time you get a fill. Its normal to have lost a small amount of fluid over time . Maybe ONCE in a while but not EVERY Fill. My fills were included in my first yr . But im still getting fills and unfils ( i have a sensitivty to fills ) Some fills i have to get under flouro still to check the band . But sometimes my doc waives that fee.

What it boils down to is trust. You have to trust the person your going to. If you dont trust the amount they are putting in ask them to see the syringe. Ask them to pull out what is in there now so you see exactly what you have in your band. I know exactly what is in my band, what goes in and what comes out every fill. My doc shows me .

Mindy

Hey all,

If you're familiar with Fill Centers USA, I'd like your feedback regarding their fill policy. They say if you get an overfill, you can come back within 72 hours and get it emptied at no additional charge. However, for underfills, there is no protection and you're charged an additional 165.00!! This doesn't seem fair. My doctor (the only Fill Center doc in Utah) is conservative, and I got a fill yesterday and I'm still feeling no restriction. Any comments or suggestions?

Also, when I signed up for their services a couple of years ago, they promised me 150.00 for fills. Then they upped their rate despite their statement that fills would always be 150.00. This also seems shady to me. But they stood their ground.

Dr. Muse was aggressive with me. (the Utah center location) Only took 2 adjustments to get to goal. He followed INAMED's guidelines to the letter. I was so worried, like you, that I'd get a doc who wouldn't follow the guidelines...in my mind-to make extra money.

The book says 2cc in a 4cc band and then .5 after that....well, that's what I got.

After I met goal I went back to get a slight unfill because I was 10 pounds under goal and all it took was 1 adjustment-unfill. My weight has remained stable since(+/-5 pounds).

My suggestion is be an informed consumer. Read the book that came with the band (your surgeon should have given it to you). When you get your first adjustment 6 weeks after surgery you KNOW before you get there how many cc's you are going to get. If you aren't getting it-ASK why you are not getting the recommended fill.

Your doc is working for you on this. If you want to be aggressive, your doc should assist you in this. If you want to take it a bit easier, he should help with this as well.

Edited January 7, 200917 yr by lapbandtalker

Dr. Muse was aggressive with me. (the Utah center location) Only took 2 adjustments to get to goal. He followed INAMED's guidelines to the letter. I was so worried, like you, that I'd get a doc who wouldn't follow the guidelines...in my mind-to make extra money.

The book says 2cc in a 4cc band and then .5 after that....well, that's what I got.

After I met goal I went back to get a slight unfill because I was 10 pounds under goal and all it took was 1 adjustment-unfill. My weight has remained stable since(+/-5 pounds).

My suggestion is be an informed consumer. Read the book that came with the band (your surgeon should have given it to you). When you get your first adjustment 6 weeks after surgery you KNOW before you get there how many cc's you are going to get. If you aren't getting it-ASK why you are not getting the recommended fill.

Your doc is working for you on this. If you want to be aggressive, your doc should assist you in this. If you want to take it a bit easier, he should help with this as well.

I too got 1.4ccs in a 4cc band the first fill and it got restriction w/ that . I have had issues w/ my fills and myself being sensitive w/ them but since then i got .5 or .25 cc's .

Not everyone is going to get to goal w/ 1 or 2 fills. But I agree if a doc is giving you .5 cc fills every fill something is not right. They are milking you and I would raise hell !

HTH

Mindy

Did i read this right ... they tell you you have lost .5c''s EVERY Time you get a fill ? If that's the case something is wrong and you might have a leak ! you should not be losing ANY Fluid every time you get a fill. Its normal to have lost a small amount of fluid over time . Maybe ONCE in a while but not EVERY Fill. My fills were included in my first yr . But im still getting fills and unfils ( i have a sensitivty to fills ) Some fills i have to get under flouro still to check the band . But sometimes my doc waives that fee.

What it boils down to is trust. You have to trust the person your going to. If you dont trust the amount they are putting in ask them to see the syringe. Ask them to pull out what is in there now so you see exactly what you have in your band. I know exactly what is in my band, what goes in and what comes out every fill. My doc shows me .

Mindy

Today had another fill he took me to 8cc's and I had 6cc's of the 6.1 that was suppose to be in there so I am not really concerned I have a leak,ask the doc about the lost cc's and again he assured me not to worry he don't really know where it goes.He said fills are not an exact science sometimes we have air in the band that has to work itself out,and maybe sometimes he loses part of a fill pulling it out and it is even possible for the port to lose a smidgen while it is healing so unless we lose alot he just don't worry about it.Dr.Wizman is not only a doctor but a Proctor aswell so yes I do trust him and his experience.I am sure in his years he has seen it all.

Edited January 9, 200917 yr by Bamagal

Today had another fill he took me to 8cc's and I had 6cc's of the 6.1 that was suppose to be in there so I am not really concerned I have a leak,ask the doc about the lost cc's and again he assured me not to worry he don't really know where it goes.He said fills are not an exact science sometimes we have air in the band that has to work itself out,and maybe sometimes he loses part of a fill pulling it out and it is even possible for the port to lose a smidgen while it is healing so unless we lose alot he just don't worry about it.Dr.Wizman is not only a doctor but a Proctor aswell so yes I do trust him and his experience.I am sure in his years he has seen it all.

If you go back next time and you have less than 8cc's I would question it. I do not believe it is normal to lose saline EVERY TIME you have a fill ! A tiny tiny amount maybe ? But I have had the exact same amount every time i have gone back for my fills! Some of the liquid can be trapped in the line between the port and the band, some might be air. But not every single time. proctor or not docs can make mistakes. its up to us to question them as well. So if you have less than 8cc's next time I would ask him to check your band under flouro just to b e sure !

Mindy

for the first three months when I got fills they were all under flouro and at that time I was checked for leaks placement ect.and as I said this time it was just .1 lost so little most would not even notice much less make a note of it but he is very attentive to ever small detail but yes if it much at this point I would be concerned after 8cc all the air should be gone.

I use Fill Center USA and I've not had the problem with them being to conservative with mine, I'm a little less then 6mo. out and have had 2 fills and a slight unfill. I'm now at 4.4cc in a 10cc band with a 9cc fill level. And can't make up my mind on rather I need another yet or not. Some days I feel I can eat more then I should and other days I still get stuck or PB. So I've just been waiting.

The only thing i have to say is that you sound hostile towards ME over this policy .

I pay my doctor for an office VISIT and the fill each time i get a fill. We discuss how things are going for me , what im eating ect. It takes longer than 10 minutes.

My doc has ALWAYS said and i have heard from others fills can take up to 2 weeks to either get the FULL affect or to realize they did not work .

I am not trying to be rude but If you did not like the policy before hand then why go to them ?

each person is different when it comes to the band. I dont see how they could possibly set a policy for the band fill or unfill for that matter, ( which is what i meant its lucky they dont charge for unfills ) for people when it comes to fills.

Fill centers , in my opinion make money from people who were banded else were and either did not set up after care else where before hand or need after care.

Are they taking advantage ? Probably .

However most people i know hwo are self pay pay around $100-$150 per fill . Is it right ? I dunno . I do know the docs make more money from the surgeries than they do the fills.

As for your question , I have NEVER EVER had a fill that I have known with in an hour if it will work for me or not . One way or another , if it was going ot be too tight or not . NEVER has that happened to me. I have had fills tighten up on me as long as a month out . Is it safe to say docs usually guess ? to a certain extent yes.

my doc would laugh at me if i walked in there and said " HEY give me such and such amount of a fill " He would look at me like im nuts . It all comes back to if you did not like fill centers policies then maybe you should not have gone to them ?

that's my input

Mindy

Mindy,

I apologize if I've come across as hostile. I believe this website has an area that you can submit complaints about posts. You're welcome to submit my post to them.

I thought I'd give you a heads up that when you post messages on discussion boards, using all caps for words or phrases is considered yelling, and that too could be interpreted as hostile. I've noticed that in your posts you have a tendency towards 'yelling', so perhaps you might tone that down.

Also, when you start a post with 'the only thing I have to say to you is that .... ", it's usually best to limit your post to the statement you make following that statement. When you make that statement and then continue to elaborate for another 1 or 2 paragraphs, you're contradicting yourself. Just a friendly tip. :thumbup:

With regard to your subsequent post, it sounds like you've misinterpreted my original post. Perhaps I could clarify some things for you.

First of all, your experience with your doctor does not reflect everyone else's experiences. There is no evidence that your experiences with your doctor represent the majority of other bandsters, either. So when you insist that your doctor and you are always right, and we cannot have experiences that contradict yours, I think you're being unfair. We're all entitled to our opinions, just as you are.

Yes, fills can take up to two weeks to either get the full affect, or to realize that they did not work. Note your use of the word 'can'. This word indicates that whatever 'can' be done is not an absolute. If fills 'can' take up to two weeks, you're also suggesting that they also cannot. This contradicts your original argument that fills 'cannot possibly be right or or wrong within 24-48 hours'. Apparently, they 'can'. Again, you appear to be speaking for the majority of bandsters. Even if you're correct, my experience is that I know within an hour or two whether or not my fill is correct. If you have any scientific evidence that backs up or suggests that your experience is right, and mine is wrong, I'd be interested to take a look if you'd share it with me. If I'm learning too quickly that my fills are working or not, I'd like to address it. In your original post you insist (or rather shout) that there is 'no way' of knowing whether or not a fill is working within 24-48 hours. I know many doctors who would beg to differ. One doctor who filled patients in Texas whipped 5 or 6 patients out of the flouroscopy room in an hour. Following the fill, patients were asked to sip a cup of Water. Depending on how that felt to them, the doctor would adjust their fill. Many patients came in from out of town. This doctor was aware that it would be unreasonable to fly back to Texas if he was inaccurate. He reassured me that testing the fill within a few minutes of the fill would in fact be indicative if the fill was correct. Dr. Kuri and other doctors I've spoken with suggest the same thing. Does this mean that that they're right and your doctor is wrong? I don't think so. These doctors who have done thousands of fills are speaking from experience.

I'm glad that your doctor takes the time to chit chat with you for more than ten minutes. He sounds like a nice guy. However, by sharing this with us, do you mean to suggest that every other doctor who does fills follow the same procedure? Or perhaps you're suggesting that my experience is all in my head? When I say that my fills take 10 mins. or less, that's what I mean. Perhaps some of Dr. Kuri's bandsters could testify to this, as I've seen him perform multiple fills within an hour.

With regard to the Fill Center's policy on adjusting fills. You suggest that you don't see 'how they could possibly set a policy for a band fill'. But they already have, Mindy, haven't they? Perhaps you could explain to me why they charge for an unfill, but not an underfill? If you can do so, I'll be impressed. Because they themselves cannot, and they set the policy. Since a fill and an underfill take about the same amount of time and skill, the only difference is that with the fill, they're using a little more Fluid than with an underfill. This suggests that the 150.00 that they're charging is for the additional fluid. What else would justify the difference? Does this make sense to you? It doesn't to me. I don't think a few cc's of fluid is worth 150.00. Furthermore, whether they overfill or underfill, the bottom line is that they've been inaccurate. I'll concede that this doesn't mean that they've necessarily made a mistake, but for 150.00 and the knowledge that they're merely guessing on the right fill, I think it would be reasonable for them to allow one adjustment if the fill is incorrect. When they charge you if they're wrong, I think this is unfair. It may not be their mistake, but it certainly isn't our mistake. So why should either of us be penalized with an additional charge? I should re-emphasize that they know that they are merely guessing. When I purchase a gift for someone, but I'm guessing whether or not they'll like it, most stores have a policy that I can return that item with 30 days. Many doctors have policies that the guess they've made on a diagnosis is just that, a guess. My doctors often invite me to give them a call if my symptoms change or indicate that their diagnosis is incorrect. They don't charge me again for that phone consultation, even if it lasts 20 minutes or longer. This is reasonable. They recognize that medicine is not an exact science, so charging patients for every time that they're wrong would be greedy and unfair to their patient. I acknowledge that there may be some doctors who charge additional money for phone calls. There may be doctors who charge money for a follow-up exam if they've missed something. However, this has not been my experience with my doctors. I think fill doctors realize that filling bands isn't an exact science either. They know that they are guessing. Charging additional money when they're wrong is simply greedy, and it's also more profitable for them.

When you state that 'each person is different when it comes to the band', I'm not entirely sure that this supports your argument against this policy. Since every patient is different, and doctors are aware of this, it seems unfair that some patients are penalized because they're different than the patients who get their fills right the first time.

You suggest that your doctor would 'laugh at you' if you told him exactly which amount you wanted him to fill. That was my original point. Doing so would indeed be ridiculous. I used that example to illustrate that the only justification I can think of for charging 150.00 when a doctor is wrong, is if the patient 'guessed' the fill and the doctor merely followed orders. In that case, the patient made the mistake and the doctor did not. So fine, charge the patient. I know of some bandsters who are so familiar with their band and which fills work for them, that they can in fact pinpoint which fill works for them, and they're probably right most of the time or they'd leave it to their doctor's discretion. Your doctor might laugh at you if you told him which fill you wanted, but many doctors realize that their patients know their bodies better than they do, and they respect their patient's judgement call. If your doctor would laugh at you if you advised him how much of a fill you wanted, that is unfortunate. It indicates that he has no respect for your knowledge of your body and what works for you based on your experience. I find that doctors who listen to their patients and then offer their opinions are much better doctors.

Since you yourself suggest that it is 'safe to say that doctors guess', you're acknowledging that fills are not an exact science. I agree, and because of that, I'm refuting this policy. You also suggest that 'fill centers probably take advantage' of patients. By acknowledging this, you contradict your orginal argument that the Fill Center's policies on profit are perfectly reasonable. Is it reasonable to take advantage of a patient? I don't think so.

Yes, most doctors make more money off of the surgeries than they do on fills. I don't understand how this is relevant to our discussion though.

The Fill Center does provide a valuable service, Mindy. I haven't suggested otherwise. Especially when it comes to bandsters who have had their surgeries elsewhere. But in my opinion, valuable service doesn't justify taking advantage of a patient. A slightly higher fee of 15-20 is reasonable. But the Fill Center is a monopoly, and monopolies have rarely been viewed as being fair. Take utilities, for example. They know that customers can't go anywhere else for their electricity or heat, so they charge a premium for their services. Is this fair? Maybe. But I'm especially giddy when competition forces price decreases for companies like this. When monopolies are broken up, consumers always win.

Why do I use Fill Centers? Because as I suggested in my last post, they have me over a barrell. There aren't many doctors who do fills in Utah. So Fill Center is convenient for me. Is that convience worth the excessive fees that they charge? No. But my only alternative is to go to even greedier doctors who charge upwards of 500.00 for fills. This is one of the few positives associated with Fill Centers. However, if more doctors in Utah learned to do fills, and the increased competion forced Fill Centers to lower their prices, then my question is this: were their original fees reasonable? I don't think so. It suggests the exact opposite of this.

There are many services that we as consumers utilize, and we don't agree with all of their policies. Can you think of a personal example of this? Are you perfectly happy with all of the companies you deal with? Especially when they have absolutely no competition? If so, congratulations. You have exceptional luck in this one area. Suggesting that I should 'go elsewhere' because I don't like one of Fill Center's policies is ludicrous. It is unreasonable as well.

So Mindy, I understand that you are not trying to be rude. However, I do think that you've been argumentative. I think we've both spent enough time on this debate for this discussion post. I'm happy to discuss this with you via email if you'd like. Let's give others the opportunity to share their views on our discussion and try to learn from them without attacking them, okay?

Best of luck on your continued success,

Miya