Choosing a surgeon: Who can you trust? 5 key factors
Choosing a surgeon is choosing a partner to help change your body…and your life. This is a big decision. There is a special level of trust that must be present not only to let someone perform a procedure while you are asleep, but to carry you through until you have recovered. How do we make these decisions? How do we make good decisions? How do you judge competence? What should a patient look for in their surgeon? Here are 5 key factors to consider:
Training
Learning to operate is an apprenticeship. Surgeons spend many years under the direction of a senior surgeon observing, learning techniques, learning hand-eye coordination skills, understanding the three-dimensional nature of the body and its relationships between tissues. There is a level of precision within the art of knowing how to manipulate the body carefully and with purpose. Some training programs are better than others and better prepare a surgeon for their career. Look at your surgeon’s education, residency and fellowship programs. Did your surgeon spend any extra time studying your problem in a fellowship program? Most fellowships give an extra year of speciality training in a field of interest. If you need your ACL reconstructed, find someone who spent a year in fellowship training in sports medicine.
Experience
How many procedures like yours has your surgeon done? It’s a fair question that most of us will freely answer. As my patient, I want you to understand my strengths and when I might refer you to someone with more experience. Someone who does a common procedure, like the ACL reconstruction, should do more than 12-15 a year. The surgeon with a high volume of procedures is more time-efficient in the OR, has encountered numerous variations in anatomy and able to adapt quickly.
The Team
Who works with your surgeon? What is there level of training? Can you expect him to perform the entire procedure, or do other assistants do a big portion of it? Physician’s assistants or assisting surgeons are commonly used, and needed, for many operations. Ask your surgeon if he uses assistants and what level of the procedure they perform. An experienced assistant can be like having another surgeon in the room. Personally, I believe the surgeon should try to be present start to finish and attending to each step, not just there for the ‘critical’ portions. All portions of the procedure are critical.
Trust
This is an intangible—do you trust your surgeon? Listen to the voice in your head telling you this is someone you can trust or not. Remember, it’s your life and limb at stake. Spend time with your surgeon in the office and discuss the problem and solution in detail. Have him educate you and your family about it and come away with a good understanding. Record the conversation if you need. Bring a list of questions. Trust comes from something one cannot explain but needs to be there. If not, look elsewhere. Travel if you need. Its YOU we are talking about. You may only get one chance.
Bedside manner
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Connect. Does your surgeon understand you and your concerns? Your surgeon is someone you need to relate with and freely discuss your condition. He or she should be there for you, answer all your questions, take phone calls, answer emails, and care about you. If this doesn’t go well before surgery, imagine how it will be after! If he doesn’t have the time to talk, how can you know what to do next?
Be informed and educated. Take part in the decisions about you. Engage !
Dr. Scott Hacker is a fellowship trained Sports Medicine Orthopedic Surgeon in San Diego, CA and Team Surgeon to the US Olympic Team. He specializes in sports medicine and sports injuries, knee and shoulder surgery.
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Thank you for the post on choosing a surgeon. I definitely like the idea to meet and make sure you trust the surgeon. Getting references is a great way to help narrow the search and speak with past patients on the work the surgeon did.