There are many health reasons to give up cigarettes for good, and you can start today as part of the American Cancer Society’s Great American Smokeout, but if you need another reason to quit you may be motivated by knowing that smoking could lead to a doctor refusing to perform surgery on you. In February 2018, the Charlotte Observer reported that a growing number of physicians have begun to ask patients to quit smoking or at least stop four to six months before and after the surgery.
According to the Observer, smokers do not fare as well as non-smokers following spinal fusion surgery and joint replacements, and one study found that smokers had an 80 percent higher chance than nonsmokers of needing repeat surgery after a joint replacement because of complications from an infection. This is because smoking inhibits blood flow, which in turn inhibits healing.
The Observer also reported that most doctors are paid through fee-for-service systems under which they are reimbursed for every appointment, test, or procedure and, thus, make more money when a patient has complications. Some surgeons who perform spine surgery and knee and hip replacements in Charlotte, however, have started using “value-based” systems in which a single “bundled payment” is accepted for each patient encounter. A doctor or hospital keeps the savings when care is delivered for less than the contract price but must absorb the extra cost when there are complications for which the patient requires additional care.