Why is it so hard to get my doctor to agree to hysterectomy?

This one has a lot of layers, Friends, so strap in!

One of the first things to consider is that a hysterectomy is a major surgery and is costly both in a financial sense and with potential risk for complications for the patient.  With respect to the financials, the cash price for a hysterectomy is over $60,000-$65,000.  (Of note, about $58,000 of that is the hospital fee.)  Most of us don’t have that kind of money just lying about to put toward a hysterectomy.  But your insurance company doesn’t want to pay that kind of money for your hysterectomy either, so they do put forth hoops for you and your doctor to jump through in order to get insurance coverage for the surgery. 

With respect to the potential risk of harm to the patient, general risks of surgery include pain, inappropriate bleeding, infection, and injury to nearby structures such as the urinary tract or bowel.  While these complications are rare, they certainly do happen, so a good surgeon is going to carefully consider the risks of surgery compared with alternative management options for each individual. 

So what is the checklist for being able to get a hysterectomy?

Here’s the checklist.

1. You must have a problem that the insurance is willing to cover such as heavy periods, pelvic pain, fibroid tumors on the uterus, endometriosis and so forth.  “I don’t want my uterus anymore” or “I don’t want any more babies” are not considered good enough hysterectomy reasons for the insurance company to be willing to pay for the surgery.
2. You will need bloodwork and imaging that further proves the medical problem warrants a hysterectomy.
3. You will probably need to complete a trial of something medical (like a pill or an IUD, for example) to manage the problem for at least 3 months with insufficient improvement of problem.