how do you select a surgeon?

How does one go about finding & evaluating a potential surgeon? My doc referred me to one for foot & ankle related surgery, but I don't think she really knows if he is the best choice. It's hard to find out much info beyond just where they went to school, residency, certification, etc.

As far as certification, ABMS does not have a foot and ankle specialty, just Orthopaedic Surgery certification. Would a FACFAS cert(fellow;amer. college of foot & ankle surgery , [podiatry]) be just as good as, or better than, a general Orthopaedic Surgeon certification ? (for a foot/ankle surgery?)

I asked this guy how often he did this surgery, and he said it was kind of rare, and he does much harder stuff all the time...sounded like a politician- i.e. he never directly answered the question. Since he would not answer directly, I conclude that he has never done this procedure before....

But how would I find some surgeon who has done the procedure? Just call up all the local offices and ask if anyone there has done it? Or what?

I found some names of surgeons who wrote a lot of papers about this procedure. But, I suppose that just having written a lot of papers does not mean they must be good surgeons?

I did get a recommendation/name of a surgeon who has experience in this procedure, but who is out of state. Since a lot of rehab and follow-up will be required, I hesitate to go to someone out of state. If problems or follow up visits are required, that would be difficult.

Good questions. Could be a tough decision. The more limited your options, the tougher it could be.

One way to start would be to contact the folks who would be overseeing your post-surgical rehab. Start with local PTs and orthopedists and get their thoughts/suggestions. It may be that you can have the surgery elsewhere but do most/all of your followup and rehab locally. Telecommunications has facilitated better cooperation between local and distant health care providers.

See if you can get a short list of potential surgeons, both local and distant. Expertise in this specific procedure is preferred, but not always necessary for success. Consider the candidates' overall success rates and reputation with the rehab folks. Also consider whether someone has assisted in performing the procedure, or had a chance to work closely with a surgeon that has performed the procedure.

Hope that helps!

Jason Erickson
www.CSTMinnesota.com

Thanks...
There is no hurry to get this done, so at least I have plenty of time to get another opinion(s) and come to a decision.

But I was just thinking today, if I imagine myself in the local ortho. surgeon's place...(empathy, yah know?)...I would not be too enthusiastic about doing the follow-up on the out-of-state surgeon's work. (1) it's kind of a blow to the ego that she did not think I was good enough to do the surgery myself (it seems that surgeons, like fighters , tend to have/need(?) big egos) (2) the out of state surgeon gets most of the profit from this, while I have to do the 'dirty work' and drudgery of follow-up (3) if the surgery succeeeds, then the out-of-town surgeon was brilliant (4) if there is an infection, or things don't work out well, I may be blamed, or liable....

Ah well. I probably am over-worrying and over-analyzing all this.

my pt has been in business in this city for 19 years.

i run everyone past her, because she sees the results of their work in the gym during rehab.

she's never steered me wrong.

Best thing to do is to talk to folks you know in the health care business. If you know other surgeons, scrub techs, or even anesthesiologists talk to them. Better yet talk to residents in a training program. They usually work with all of the attendings and they follow up their patients in clinic and also on the floors...they have the inside scoop.

You need to talk to physicians or personel that work in the OR. Talking to a primary care doctor or someone on the nonsurgical medical world is NOT the way to go. Believe me they have no clue whatsoever.

You need to talk to physicians or personel that work in the OR. Talking to a primary care doctor or someone on the nonsurgical medical world is NOT the way to go. Believe me they have no clue whatsoever.

chooy721 - You need to talk to physicians or personel that work in the OR. Talking to a primary care doctor or someone on the nonsurgical medical world is NOT the way to go. Believe me they have no clue whatsoever.


true dat.

I had a complete pec tears 5 years ago - family doc, the physio therapist and original sports doc had no fucking clue,

If you have a sports medicine doc that works with major league sports teams may be a way to go.

I got a sports doc that works with the raptors and other prof sports franchises in Toronto. Turned out that he had just completed a study with an orthopedic surgeon that specializes in pec tears & the two of them had just completed a study on surgical procedures.

It's only been 5 days but since the procedure & its going great.

Doctors refer you to their buddies.

NURSES refer you to the best doctors.

One of the best decisions I ever made was to trust a nurse's referral to a back surgeon. She would allow me to see one of two doctors... and no one else.

That surgeon gave me my life back.

Thanks for this info.

Select a surgeon who is very conservative and who makes it clear that he/she will not cut you for the sake of working.

Also, look for surgeon with academic appointments at medical schools/teaching hospitals.

Don't be shy to shop around for the best fit for you. Some doctors don't like this, but its too bad...its your body. I don't mind when others shop around and tell me this when they visit my clinic.

Good luck!

I tore my pec while benching. I had the surgery on 15 APR 09. Being in the Army, I guess I had no choice in choosing who repaired the injury. I guess, I was lucky. I feel brand new already, even though I am still in the sling. I will starting physical therapy in about 3-4 weeks; which I heard will be a a mutha. Charlie G, has your doc told you how long it will be before you can get back to "normal?" I wont be lifting heavy again. I made that decision shortly, or should I say immediately after I tore the pec. I know it would be awhile before I can do pushups, an Army favorite.

Gryph

I work in the OR. Out of the 200 surgeons I work with, I would only let seven even touch me.

Good idea to know someone who works in the OR or they have a family member that does.

One of my clients has severe hip issues, and has elected to have hip resurfacing surgery. After researching the hell out of her options, she has found one of the top 5 surgeons in the world to do the job - in India.

While the Mayo Clinic has done about 7 of the procedure she needs, this Indian doctor has done over 140. Who do you think is likely to get better results?

Anyway, she also learned of a travel agency that specializes in "medical tourism". They are coordinating all her travel, the surgery and hospital appointments, the post-surgical recovery facilities, food, EVERYTHING. They got her an all-inclusive package deal that includes round-trip airfare. The total price: $10,000 - slightly less than her insurance copay if she had the work done locally by a surgeon with far less specific surgical experience.

Be picky.

Jason Erickson
www.CSTMinnesota.com

Just to follow up on my original post- Feb. 2009 I had posterior tibial tendon transfer surgery done by a local podiatrist. Did PT and was walking well without AFO soon afterwards.

HOWEVER. Surgical wound on top of foot did not entirely close. 3 months post surg, Tendon & sutures exposed, tendon becoming necrotic. Referred to wound care specialist. Re-sutured 2x, dehisced 2x. Debridement weekly. Bigger wound, infection. Antibiotics, Back to crutches. FTSG,looked great at 3 weeks, then failed. Bigger wound, Debridement weekly. APG a week ago, seems to be working.

It's been 6 months since the surgery and there is still an open wound. Long story short, if I could do it over again I would not go back to this same surgeon. Even though I can lift my foot up (the objective), it can't be considered a success when I still have an open wound at 6 months post surgery!

But hey. How 'bout that APG??? (Autologous Platelet Graft?) One week after my 1st one the wound had decreased from almost 1 in2 down to 0.1 in2!! It was just incredible. But that last little 0.1 in2 is the hardest, because that's where the tendon is sutured to the anchor in the bone on top of the foot. Skin seems to think it's foreign matter (well it is) and does not want to close over it. I just had the second APG and can hardly wait to see if it will close now. (please, please, please..)(if it does close I may come on and post about how wonderful and amazing the APG is...it's used for all kinds of different things...)

Ray Blackburn is right on the money