We send any suspicious skin lesion to the pathologist to have them identified and the margins (normal tissue around the lesion) checked. The patient always has the option to send any lesion to have it identified but many of the things we remove are benign-appearing and don’t need to be checked by a pathologist.
We do not do hemorrhoids, pilonidal cysts, genital warts, ganglion cysts. We don’t do X-rays so we don’t deal with fractures of bones. We would send any hand laceration that involved nerve or blood vessel damage to a hand specialist. There are occasionally skin lesions of the face that require skin grafts or flap procedures so we would recommend a plastic surgeon. We also occasionally send patients to dermatologists when indicated.
It might be if you only have one skin tag or “benign mole” to be removed. However, most people have more than one of these things and we tend to “bundle” them and charge the same fee for 5 or 6 of them as we would for one. Dr. Redd will talk with the patient before the procedures are done and discuss the price and why we charge what we do.
There’s a good reason for that. To my knowledge, we are the only such clinic in the South, maybe even in the USA! Think of an urgent care center that only does minor surgical procedures but with a few (good) modifications:
A surgeon will always do your surgery. That’s very important to us and to you.
We don’t do primary care. We do a few things and we do them well.
Time is important. We see patients within 5 min of their appointment time.
Money is important. We have cash prices that are affordable and fair.
“Minor” surgery is defined by a surgeon as a procedure that can be done safely under local anesthesia. That means that a numbing medicine (lidocaine, most commonly) is placed by a needle just under or around the area of concern so no pain is felt by the patient.
“Minor” surgery is defined by all patients as… surgery! So, the expectation is that a surgeon is supposed to do it. Patients (rightly) should want a surgeon to do it, but there are healthcare facilities where this is not the case. Whether it’s major or minor, an experienced surgeon is what you can expect when you visit QuikSurg.
We don’t operate with any kind of anesthesia other than local anesthesia. We don’t put people to sleep (general anesthesia), we don’t do conscious sedation (sedative pills or IV meds). We cannot perform a surgery if you are on a blood thinner medication and can’t stop it for any reason. We don’t operate on kids; you must be 14 years or older. There are a few procedures we don’t do that are usually done under local anesthesia, just ask.
The Medical Side: Urgent care clinics have been a great step forward in personal medical care. Before they existed, a bad cough/cold or an ear-ache or sore throat would mean a trip to the ER, especially after hours. Now, things that are “urgent” are seen at these clinics before they become “emergent”. Urgent care clinics often have nurse practitioners or physicians’ assistants providing this primary care.
The Surgical Side: The concept of having urgent care that all surgical urgent care and not primary care is the way of the future. Think about the last time you had an abscess on your skin that needed urgent attention. Where would you go to get it looked at? A true surgical urgent care can be much more nimble in it’s approach to patient care, providing:
Minimal wait times
An experienced surgeon to do your surgery
The anesthesia is local, directly applied to the area of surgery only
Prices are posted online for those not wanting to use their insurance
Your appointment time is your procedure time so no wasted time
We do. Although we call it a Procedure Room. We always sterilize instruments and set each procedure up for an efficient operation. Any clinic that does procedures/operations needs to be very clean and organized.
An overhead LED light is mandatory. We use local anesthesia (Lidocaine) but we never begin a procedure without first testing to see if you’re 100% numb.
Our procedures are generally short, lasting anywhere from 20 minutes to 2 hours. The shorter the case, the less chance of infection.
No. That’s the beauty of minor surgery, you don’t need to go to the hospital for everything. Here’s what you need to know about any surgery you might have.
A surgeon trained to do surgery from an approved surgical residency program. As a surgeon, I’m biased. I think all surgery should be done by a residency-trained surgeon. It’s important to know what’s under that skin when you have a very sharp knife in your hands! Too many times I have seen patients who have had things taken off or taken out by a non-surgeon and it’s a disaster.
A good working knowledge of the benefits and limitations of anesthesia. At a minor surgery clinic, only local anesthesia is used so an anesthesiologist is not necessary (as would typically be the case with general anesthesia). Lidocaine is one of many locally administered drugs that are available and it is safe and effective.
An extremely clean clinic. I think everyone would agree that a super clean environment is important. I clean the procedure room every morning and after every case. We pick up trash outside and blow off the sidewalk every day.
Patience, opportunity, time. The cost of having an operation done in a hospital or surgery center is staggering. You pay for everyone from the surgeon to the janitor who cleans up after you!
Is it safe to have surgical procedures somewhere other than a hospital? Yes, IF your surgeon has the patience, the expertise, the equipment, and the time to do it.
In most clinics, if you see a medical professional, you pay. I have a different policy for a patient that just wants a 5-minute opinion. Consultations are free. But there’s an exception… if you are using your insurance.
Important Note: You have a choice at our clinic, you can use your insurance or pay in cash (or the equivalent with a credit card, debit card, etc). If you want to use your insurance, then we are obligated to follow the rules and guidelines of your contract and an office visit will be processed.
Wouldn’t that be great? No, unfortunately, the list of things that are not covered by insurance seems to get longer and longer. That’s why clinics that have cash prices are so important. Minor surgical procedures are many times not covered, things like skin tags, ear lobe repairs, lipomas, benign moles/skin lesions.
No. Those are follow-up visits that are important to make sure you are going to do well from the procedure and “part of the deal”. I can request that a patient come back for suture removal and that’s just part of good care and should not be another charge.
Any suspicious skin lump or bump is sent to a pathologist to identify it. But we don’t send everything to be looked at under the microscope. We do send anything the patient or surgeon is concerned about. Of course, the main concern is skin cancer. The pathologist (doctors specially trained to study human cells) will send QuikSurg a report identifying the mole/lesion and if the area around the mole is “clear” (no sign of cancer).
This answer is always a bit tricky; it really only matters if you want to use insurance to pay for the procedure. Often, insurance will not pay for cosmetic procedures (“serving to beautify”). For example, skin tag removal is cosmetic as it causes no threat to your standard of life. However, If you choose the cash-based pricing, regardless of the procedure, we can do it. For example, if you want a mole removed, we will remove it—no need to decide whether it’s cosmetic.
The healthcare system in this country is set up for insured patients. If you don’t have health insurance or have insurance, but you have a very high deductible, you are a good candidate to pay with “cash” (or cash equivalent). We see more cash-based opportunities, especially in outpatient medicine and surgical procedures. It makes sense to pay a (typically) lower cash price if the fee would otherwise come out of your insurance deductible. However, to answer the question of why most clinics don’t post their cash prices? I don’t know. They probably have cash prices for people who come in and don’t have insurance, but they choose not to publish them.
You are describing a possible abscess. An abscess takes a very short time from “ok” to “hurts like crazy.”
Abscesses typically show symptoms in 4 ways: swelling, skin redness, warmth, and pain. Add in bacteria (usually Staph), and they take off. Once those symptoms arise, you are a candidate for getting the abscess drained and starting an antibiotic. That abscess is a collection of cell debris, bacteria, and white blood cells, and there is only one cure for it; you need to have it drained, and then a tiny fabric piece (a wick) is placed in the wound to allow it to continue to drain. You’ll need to return in a few days, and we will change or remove the wick and manage this infection. On your return visit, you will be feeling better.
Sounds like a lot of fun, right? The abscess hurts so bad it’s hard to sit down, and now a doctor wants to open it up! I tell all patients that Lidocaine is a godsend because it allows them to be opened and drained without pain.
A lump or bump visible under the skin is often one of two things: an epidermoid cyst or a lipoma. Do not worry; both of these are benign (not malignant). They can, however, continue to get bigger over time. Both are treated the same way. A lipoma is a benign tumor of fat. An epidermoid cyst is a sack filled with a protein called keratin, which has the consistency of thick toothpaste. There is a wall around the cyst contents that keeps it contained to one area.
Since, In this case, it’s probably a cyst; let’s talk about cysts and what to do:
I always recommend that a medical professional surgically remove a cyst because of the risk of infection. We all have bacteria on our skin that are “friendly” unless they get access to the cyst. How? By picking at the cyst or squeezing out the “white stuff” (keratin). The problem is, even if you could get every bit of that stuff out, the cyst wall is still there, and the cyst will fill back up over time. You haven’t solved the problem, delayed it, and may have allowed bacteria to sneak in.
Any cyst surgery aims to get the cyst contents AND the cyst wall. If an infection has already set in so that an abscess has formed, it can be double trouble, but the abscess takes priority. Most of the time, the abscess can be drained, and the entire cyst can be removed. If not, the abscess has to go, and the cyst is
removed in a second operation weeks down the road. No one knows what causes these cysts. Your body produces the keratin naturally to go outside your body to act as a waterproofing, not inside a cyst. It is still a mystery why it goes under the skin and forms a cyst with a wall. The good news is they can be cured, and it can be done under a local anesthetic, not in the hospital OR.
One last thought: If you have a lump that could be a cyst that starts to get slightly tender and red, seek medical help immediately because an antibiotic can “cool things off” until you can remove the cyst. It’s not wise to think that antibiotics are the cure; the cure is cyst removal.
Yes, we do. It’s good to know what a lipoma is and what it isn’t:
Lipomas are fatty tumors. The important thing to know is they are almost always benign and not malignant tumors. Benign tumors get bigger where they are. Malignant tumors get bigger and spread to other parts of the body.
As I discussed in the FAQ about skin cysts, a lump right under the skin that can be seen or easily felt is usually a cyst or a lipoma. Cysts can get infected. Lipomas rarely get infected, so there’s rarely an “emergency” lipoma. They can be the size of a pencil eraser or as big as a California grapefruit.
Lipoma removal can be done in a clinic setting for surgical procedures but requires a surgeon with experience removing them. They can be easily removed or technically challenging because of attachment to the surrounding tissue.
This surgery can take up to 2 hours, so it’s important not to go to a “walk-in” for larger lipomas. Also, there are rare lipomas that have a cancer component, so a work-up that includes an ultrasound and MRI scan is needed before surgery. These operations are done in a hospital.
Almost most certainly NOT. Whether wire, nails, glass, splinters, or fishhooks, these are called foreign bodies, meaning they don’t belong in you. The rule of thumb that surgeons use when assessing a foreign body is, “If I can feel it, I can usually find it.” Here are a few other things you may need to know:
Biological splinters (wood, bamboo, cacti, etc.) will tend to “fester” (get sore, red, and warm to the touch) and need to come out sooner rather than later.
Non-biological splinters (wires, metal fragments, glass, bullets, etc.) can do OK in the body for a while, but they also tend to work to the surface and eventually cause some discomfort.
Some foreign bodies can show up on X-ray, like metal or leaded glass, which can be helpful, but going after something you can’t feel or see is usually unsuccessful.
Dr. Redd did have a patient come into QuikSurg a few years ago who had been shot four times several years ago, with one of the bullets lodging in his left shoulder. He could feel it easily now and wanted it removed. Dr. Redd was able to remove it, it was a 44-caliber slug, and he was glad to have it gone. When asked why they didn’t take it out at the hospital, he said, “They were too busy putting my colon back together from the other three bullets!”
(BTW, the patient who asked this question did have a wire in his arm, and Dr. Redd was able to remove it!).
Dr. Redd is convinced that picking at skin lesions is not the best way to get rid of them. Most “pickers” end up at a clinic for the following reasons:
Scratching at a skin lesion is a recipe for infection. Humans have bacteria under fingernails that can infect a scratched area, and what was once just a lump or bump can turn into an infection or abscess.
If a skin lesion is successfully removed by picking it, it will likely return because you didn’t get it all. Tiny parts of the lesion remain on your skin and will start the process again.
You might be picking a potential skin cancer that needs to come off!
What should you do?
Stop the picking and see a surgeon at a minor surgical clinic where these things can be quickly and safely removed. If it needs testing for cancer, it can be, and the temptation will be gone.
Despite the fast-moving trend towards all things automated, at QuikSurg, we believe a patient with a problem or question about their health wants to talk with a human being.
Here is where a recording is helpful:
If the clinic is busy and has limited staff, a recording can be helpful, IF the team is good about calling the patient back ASAP. Our clinic runs into this situation occasionally when we are in a procedure. When the phone rings, it will roll over to a recording, but we always try to call the patient back quickly.
If it’s an emergency and the clinic is closed, it’s necessary to have a recording with instructions to “call 911”.
They are a conversation starter and help take your mind off the procedure; they are 2 of the best movies ever made. One of the movies is so popular that only two patients in 8 years have not seen it! (The Shawshank Redemption).