Well, Winged Scapula, if you made a mistake and knew you made that mistake...would you go to the trouble of at least waiving the patient's co-pay for the procedure to fix your error? Or do you see it differently...
On a somewhat related note, what is considered an acceptable error rate for a surgeon? I understand that zero mistakes is probably the goal, but what happens in actual practice? Also I have to agree that charging to reoperate to correct a mistake kinda seems like literally adding insult to injury...
I think you need to differentiate between "complication" and "mistake." Complication does not = mistake.
The common misconception is that a complication is a medicolegal issue (ie, a tort) which warrants suit and award. As noted above, complication = / "mistake". All surgeries have known complications. If I cause the patient an injury during the course of surgery, in most cases that would be a known complication and risk of surgery. For example, a commonly litigated complication is a bile duct injury as a result of an intraoperative event during a cholecystectomy. This is a known complication of the surgery, should be covered by surgeons doing this procedure and therefore, a known risk that the patient accepts by undergoing surgery. Informed consent involves the patient knowing about the possible complications (including known and unforeseen ones), accepting those risks and being willing to proceed. Unless a surgeon willfully and wantonly caused injury to a patient (ie, assault) or fails to tell patients about a "reasonably expected" complication, a complication or "mistake" as has been described here, is not generally successfully litigated.
If a patient has to return to the OR during the post-operative (90 day global) period, there is no co-pay.
If a patient has to return to the OR during the post-operative period, they may have a deductible which has not been met (unlikely, if they have already had surgery). If a patient has insurance, you are not allowed to waive co-pays, deductibles, nor are you allowed to do pro bono work in these situations, etc. This is considered insurance fraud. The patient's insurance is billed for the appropriate code and reimbursement rates; to do otherwise is fraud and subjects the surgeon to investigation.
However, I know physicians who have felt "bad" or perhaps even "guilty" for a complication resulting in additional treatment (even known complications) and have reimbursed a patient for their out of pocket expenses. This can be construed by a jury as admission of guilt and any malpractice attorney and medical liability company will tell you never waive these charges or reimburse patients.
An acceptable complication rate depends on what you are doing. All surgeries have certain risks, some more than others. For example, the rate of major complications (ie, heart attack, stroke, etc.) in a breast augmentation is less than 1% in most patients. However, the risk of implant infection may be as high as 40%. Somewhere in between these are the risks of implant extrusion, capsular contraction, etc. I have an 8 page consent form which discusses all these things. If my complication rates wildly exceed the norm, then there's a problem that I need to recognize and rectify. However, if a complication rate is known and explained to the patient, then they have accepted that risk. Some patients will not and it is their choice to not have the surgery. Major complication rates are low for what I do; but if I were a pediatric surgeon doing Kansai procedures, the rate would probably be higher, due to the patient population and the inherent risk of the procedures. So there is no global acceptable complication rate - it depends on the patient (ie, smokers have higher complication rates almost across the board) and the procedure; average figures for procedures are known and discussed with the patient.
I share patient's frustration with the cost of treating complications and yes, it seems unfair to charge for repair of that. If the brakes on my car aren't fixed the first time I go in, I expect that they will repair it (until they get it right). However, if they need to do extra work, I expect to pay for it - if they've done something wrong, I don't. This has not translated to medicine.
Whether or not I feel that's right is irrelevant because the medicolegal and insurance environment does not allow me to fail to charge a patient (nor would the hospital fail to charge the patient for the OR, the postop bed, nursing care, etc.).
I am curious, given the "tone" of the posts above me, whether it is felt that only surgical complications should be managed for free or does this extend to all medical care? If a patient has a reaction to an antibiotic, is the practitioner responsible for paying for the prescription? Where do you draw the line on "never events"?
