How to pick an orthopaedic surgeon?

A decade of medical training (4 years of medical school, 5 years of residency and 1 year of fellowship) has put me in contact with hundreds, if not thousands, of medical doctors, including surgeons. This training has been across the United States from Washington, DC to Chicago to Los Angeles. I have learned from and observed doctors from all parts of this country and all walks of life. Throughout that time, I have witnessed countless good surgeons.  What made them good?

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As a medical professional, assessing whether a doctor would be a good doctor for a family member is a difficult task.  I don’t have first hand knowledge of my child’s pediatrician’s skills. I don’t have access to my parent’s surgeon’s records or interactions with other patients. I am essentially, in these encounters, like any other patient.  I often find myself in these situations asking myself… “Is the person treating my loved one a good doctor?”

Technology has obviously tried to help us narrow this information gap.  We have access to a physician’s educational background and website rankings, easily via the internet.  Some of this information is useful, such as, “Did my physician attend reputable educational institutions?” I believe there is credibility afforded by academic centers that are known for producing quality doctors.  But I also believe that some of this information, particularly rankings, can be harmful to the doctor-patient relationship.  Do you want the same organization who determines if you had a good experience purchasing your car also determining if you had a good encounter with your doctor? While it might be nice if the car salesman told you about the risks of the car you were purchasing, you don’t expect him or her to.  If your doctor didn’t tell you about the risks of a medical decision you were making, he or she would be negligent. Does hearing about the bad things that could happen if you underwent surgery change how you feel about the experience? Is this honest discussion often accurately reflected in physician rankings? I am not so sure about that.

This all leads me to ask a simple question. What makes a good surgeon? It is probably too difficult of a question to address in one blog post but I would like to highlight one area that I believe makes the biggest difference in the identification of a good surgeon.  I think in order to assess the quality of an orthopaedic surgeon (and I will keep it specific to that specialty) a person must ask themselves, “Does this doctor understand what I want?”

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Medicine is very much a science. We have good scientific data for a lot of what we do. I know that a knee replacement works well for the treatment of arthritis of the knee.  The art of medicine is deciding which patient is at the point that they are ready to undergo a total knee arthroplasty (knee replacement).  In order to figure out which patients are ready, I must ask myself, “What does this patient want?”  Is the person in front of me having knee pain from arthritis but about to go on a hike to Machu Picchu? If this were the case, and I were to discuss a knee replacement, I would not be understanding what the patient wants.

Ultimately, when a patient sits down with their orthopaedic surgeon, they have something that they want. It may not be explicit. Most people don’t come into the office knowing they want surgery or physical therapy or an injection. But often patients do know that they want to be pain free or to be able to return to playing tennis or hiking. Does your orthopaedic surgeon take the time to figure out what you want and then discussion treatment options that fall in line with your goals? If they do, then they are more likely than not going to be, in my opinion, a good surgeon. If they don’t understand your goals and what your needs and wants are, then it might be a good opportunity to get a second opinion?  As a surgeon, my goal is never to talk a patient into a treatment. My job is to help them understand that my treatment recommendation will help them achieve their goals and get back to doing the things that they love.

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