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Advice on how to research a surgeon?
Old 03-20-2017, 07:43 PM   #1
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Advice on how to research a surgeon?

I may require a discectomy. I've lost partial use of my right leg, surgeon thinks it's a ruptured disc pressing on a nerve root.

I've done a Google search on the surgeon and have a range of 1 star for supposedly screwing up a hip replacement to several 5 star reviews for people that he helped.

Is there a publicly accessible source for physician competence that I haven't found? His credentials online are impressive, but I know how a resume can be fluffed AND I'm from Texas where the infamous Dr. Death practiced.

I want to do as much due diligence as possible, but i'm unable to find anything other than "he's the devil" or "he saved my life" which isn't helpful.

Any suggestions?
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Old 03-20-2017, 07:47 PM   #2
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I had an aortic valve replacement in 2013. You can go to healthgrades.com and do some research there. Not only do research on the Dr., also do research on the hospital. Some hospitals have great doctors but very bad staff infection rates etc.

I also interview (3) Drs. before choosing one for my surgery.

Good luck with your research.
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Old 03-20-2017, 08:17 PM   #3
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I would also check the state's board of medicine web site. If they have taken any action against the doctor's license it would be on there.
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Old 03-20-2017, 09:33 PM   #4
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Every major medical market will have a doctors' group that's superior to all others in every specialty. And those within the medical community knows who's "da man" when it comes to different types of surgeries.

Ask your primary care physician which surgeon's superior in skills. They will usually guide you to the right group.

I have a neighbor that's an anestesiologist, and she's a source of information. I also live 5 houses from the premier general surgeon in our area--as good as they get. He saved my life when my gall bladder almost ruptured (gangrene.) I also have a number of RN's and Nurse Practioners in my church that know the best surgeons..
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Old 03-20-2017, 09:58 PM   #5
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Every major medical market will have a doctors' group that's superior to all others in every specialty. And those within the medical community knows who's "da man" when it comes to different types of surgeries.

Ask your primary care physician which surgeon's superior in skills. They will usually guide you to the right group.

I have a neighbor that's an anestesiologist, and she's a source of information. I also live 5 houses from the premier general surgeon in our area--as good as they get. He saved my life when my gall bladder almost ruptured (gangrene.) I also have a number of RN's and Nurse Practioners in my church that know the best surgeons..

Agree - seek referrals from medical professionals and as kimcdougc said, check out the hospital. Bottom line is that you need personal referrals from people you trust. Start with your primary care physician but don't stop there. Typically, physicians in a group practice or connected to a particular hospital system will only recommend internally. The key question to ask it "where would you go if it were you or your loved one?". They're not always the best, but a good place to check is the largest most prestigious medical center (usually attached to a major university). In Michigan, if I had anything I really felt was beyond a basic surgery, I'd be at the University of Michigan Medical Center.

Also, please tell me you're not getting spinal fusion. There are better options. I have a friend that had neck problems and John Hopkins had no good answer. Was about to do fusion. Long story short, I friend of a friend recommend a procedure (not sure what it's called) and the guy was off to Germany to have his neck rebuilt. He's very happy with the outcome. If this sounds remotely familiar, PM me and I'll get the name of the procedure and the doctor who does it.

Bottom line, you're on the right track. Do your homework. No surgery, especially one on your spine, is routine.
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Old 03-20-2017, 11:08 PM   #6
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I may require a discectomy. I've lost partial use of my right leg, surgeon thinks it's a ruptured disc pressing on a nerve root.

I've done a Google search on the surgeon and have a range of 1 star for supposedly screwing up a hip replacement to several 5 star reviews for people that he helped.

Is there a publicly accessible source for physician competence that I haven't found? His credentials online are impressive, but I know how a resume can be fluffed AND I'm from Texas where the infamous Dr. Death practiced.

I want to do as much due diligence as possible, but i'm unable to find anything other than "he's the devil" or "he saved my life" which isn't helpful.

Any suggestions?
I suggest looking up your surgeon on the database of the Nevada State Board of Medical Examiners, see link below. You will find details of education, certification, any licence restrictions and Board actions.

http://medboard.nv.gov

You could also search the research literature. For example, I Googled "discectomy in Nevada" and came up with this peer reviewed study from the Western Regional Center for Brain and Spine Surgery in Las Vegas. Sounds like that's a group who should know what they are doing. Is your surgeon one of the authors? Call the Center and ask if there is a surgery coordinator that you can speak with. Try to triangulate the information you are gathering about your surgeon. Don't forget that the competence of your anesthesiologist and the nursing staff will be key to a good outcome too!

https://www.ncbi.nlm.nih.gov/pubmed/22236486
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Old 03-21-2017, 01:27 AM   #7
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Thanks everyone very much for your great suggestions.

Definitely no fusion is being discussed. Discectomy is a removal of the part of the disc pressing on the nerve so while serious since it is spine, not nearly as involved or invasive as fusion.

The Germany info is interesting. I learned that i have degenerative disc disease as well which was seen today on xray. Doc was surprised I wasn't in pain from that and said fusion down the road might be indicated. Not there so there was no need to discuss.
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Old 03-21-2017, 03:45 AM   #8
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Sounds like you're seeing an orthopedic surgeon. I'd recommend a neurosurgeon for anything dealing with the spine. I have disc degeneration disease with three levels involved, plus a lumbar bulging disc. No surgery recommended after 11 years. I treat it with physical therapy, occasional medication including muscle relaxers and Vicodin as needed, and cortisone injections in my neck or lower back (facet joint injections or cervical epidurals). A pain management specialist does the injections. The neurosurgeon had told me surgery may relieve pain for a year, but would come back and possibly be worse. I'm careful not to overuse the medications and the physical therapy works miracles. You may have to try a few to find a good one. If they expect you to push through the pain, run! A good one knows it takes time and a variety of exercises to work.
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Old 03-21-2017, 11:08 AM   #9
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Sounds like you're seeing an orthopedic surgeon. I'd recommend a neurosurgeon for anything dealing with the spine. I have disc degeneration disease with three levels involved, plus a lumbar bulging disc. No surgery recommended after 11 years. I treat it with physical therapy, occasional medication including muscle relaxers and Vicodin as needed, and cortisone injections in my neck or lower back (facet joint injections or cervical epidurals). A pain management specialist does the injections. The neurosurgeon had told me surgery may relieve pain for a year, but would come back and possibly be worse. I'm careful not to overuse the medications and the physical therapy works miracles. You may have to try a few to find a good one. If they expect you to push through the pain, run! A good one knows it takes time and a variety of exercises to work.
If discectomy is the route I'll be getting at least one other opinion and more likey two. My current doc isn't suggesting I push through the pain. With my foot paralysis he's wanting to move quickly because the longer it stays this way with no improvement the more likelihood of it being permanent.
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Old 03-21-2017, 11:11 AM   #10
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If discectomy is the route I'll be getting at least one other opinion and more likey two. My current doc isn't suggesting I push through the pain. With my foot paralysis he's wanting to move quickly because the longer it stays this way with no improvement the more likelihood of it being permanent.
Very wise!
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Old 03-21-2017, 12:56 PM   #11
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I would also check the state's board of medicine web site. If they have taken any action against the doctor's license it would be on there.
I would be cautious with this. In my study of the law, I have read a number of local cases where a doctor was found negligent but yet they have a "clean record" according to the state.

In the case of my DW who was a "difficult case" (spinal tumor; second surgery) it took time to find a surgeon who would consider it. In the end, we went to a spine center (that is one of the best) and they "assigned" the surgeon that was best qualified. Initially we thought insurance was going to be an issue since he (and the clinic and the hospital in which he had privileges) were out of network, but a couple of letters that stated that no one in the network would touch her seemed to make the insurance company happy and we paid the in network cost.
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Old 03-21-2017, 01:26 PM   #12
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Typically, you want a high volume surgeon at a high volume hospital. The data are pretty clear in showing that practice makes perfect for both the surgeon and the hospital.

The best data source for outcomes that I am familiar with is Healthgrades, which analyzes the medicare database and awards 1-5 stars based upon risk adjusted mortality and in-hospital complications. Not perfect by any means, but .... https://www.healthgrades.com/ Can search for either discectomy or subsets thereof.

You may be surprised. For example, someone needing hip or knee replacement might want to travel a long way to Helen Keller hospital in Sheffield Alabama.

Edited to Add:

Propublica database on surgeons using medicare data: https://projects.propublica.org/surgeons/

One of the articles from 2015 that highlighted the data (and helen Keller...) https://bangordailynews.com/2015/07/...ref=relatedBox
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Old 03-21-2017, 01:29 PM   #13
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I would be cautious with this. In my study of the law, I have read a number of local cases where a doctor was found negligent but yet they have a "clean record" according to the state.
The website has a disclaimer about this. Just because a physician has not been disciplined by the licensing body does not guarantee he or she is highly skilled or ethical. The main value of checking the website is to outrule physicians who have done something egregious, or repeatedly breached standards, anything that would lead to discipline by the licensing body.
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Old 03-21-2017, 02:19 PM   #14
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The website has a disclaimer about this. Just because a physician has not been disciplined by the licensing body does not guarantee he or she is highly skilled or ethical. The main value of checking the website is to outrule physicians who have done something egregious, or repeatedly breached standards, anything that would lead to discipline by the licensing body.
And a think the surgeon case in Texas is a prime example of how that "protective system" isn't always so great.

Dallas surgeon gets life in prison for purposely maiming patient | FOX6Now.com

Granted, this is an occurrence that is quite rare, but it did shine a light on the system Texas had in place to keep tabs on shady MD's.
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Old 03-21-2017, 02:57 PM   #15
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Sounds like you're seeing an orthopedic surgeon. I'd recommend a neurosurgeon for anything dealing with the spine. I have disc degeneration disease with three levels involved, plus a lumbar bulging disc. No surgery recommended after 11 years. I treat it with physical therapy, occasional medication including muscle relaxers and Vicodin as needed, and cortisone injections in my neck or lower back (facet joint injections or cervical epidurals). A pain management specialist does the injections. The neurosurgeon had told me surgery may relieve pain for a year, but would come back and possibly be worse. I'm careful not to overuse the medications and the physical therapy works miracles. You may have to try a few to find a good one. If they expect you to push through the pain, run! A good one knows it takes time and a variety of exercises to work.
Every situation with the back is different. I was of the opinion to "never" have back surgery either -- until the day came I cried uncle. The MRI was impressive to say the least. Physician friends I showed it to could not believe I wasn't on a morphine drip. But I did wait 30 years or so.

Also note that injections have risk too.

In my case, my surgeon is a board ortho, but did residency in both neuro and ortho. I am happy with the results (lower back -ectomy, no fusion).

Agree that fusion is another level. And upper back is yet another level compared to lower.

And hospital matters. I chose a specialty hospital instead of the general. In my little pea brain, I felt better not being in the same building full of chronic infectious cases. I don't know if that helped, but knock on wood, no infection.

These are not easy decisions. After a while, I got what I felt was "babble" from both friends and internet research, and went with my gut. Part of my decision was the fact my surgeon did over 1000 lower back -ectomies.

To Lisa99: my best to you in your decision. Loss of use is a real indication to do something. Sending good thoughts and vibes your way.
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Old 03-21-2017, 04:13 PM   #16
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Originally Posted by Lisa99 View Post
I may require a discectomy. I've lost partial use of my right leg, surgeon thinks it's a ruptured disc pressing on a nerve root.

I've done a Google search on the surgeon and have a range of 1 star for supposedly screwing up a hip replacement to several 5 star reviews for people that he helped.

Is there a publicly accessible source for physician competence that I haven't found? His credentials online are impressive, but I know how a resume can be fluffed AND I'm from Texas where the infamous Dr. Death practiced.

I want to do as much due diligence as possible, but i'm unable to find anything other than "he's the devil" or "he saved my life" which isn't helpful.

Any suggestions?


Probably the same surgeon should not be doing hip replacements and back surgery. The skills are very different. Not sure where you live, but check out very active neurosurgeons who do high volume back surgery. Also be sure that careful rehab cannot take care of you.

I have a friend who became permanently incapacitated subsequent to back surgery.

Ha
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Old 03-21-2017, 06:32 PM   #17
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A bit dejected right now. My insurance is an "on exchange" policy and there are very few doctors on it who do discectomies.

The same insurance company off-exchange has the highest rated neurosurgeon in the area, but he doesn't take my on-exchange policy.

So while I'd love to pick the BEST, I'll have to go with who is in network. Thankfully after checking Healthgrades my doc is one of the highest rated of the ones that I can choose from.

Makes me wonder if at open enrollment it wouldn't be worth it to bite the bullet and go off-exchange even though it is almost a thousand a month. Heaven forbid this was cancer I was facing and I had limited choices.
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Old 03-21-2017, 06:33 PM   #18
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I have a friend who became permanently incapacitated subsequent to back surgery.
I was incapacitated before back surgery.
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Old 03-21-2017, 08:10 PM   #19
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Ask your friends . One of them will know nurses who work in the hospital . Look for advice from ER, OR or Recovery Room nurses they usually know who is the best and more important who is not good.
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Old 03-21-2017, 08:44 PM   #20
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A bit dejected right now. My insurance is an "on exchange" policy and there are very few doctors on it who do discectomies.

The same insurance company off-exchange has the highest rated neurosurgeon in the area, but he doesn't take my on-exchange policy.

So while I'd love to pick the BEST, I'll have to go with who is in network. Thankfully after checking Healthgrades my doc is one of the highest rated of the ones that I can choose from.

Makes me wonder if at open enrollment it wouldn't be worth it to bite the bullet and go off-exchange even though it is almost a thousand a month. Heaven forbid this was cancer I was facing and I had limited choices.
I don't know how risky your surgery is or how risky you believe it is, but if I was going under the knife, I'd find the best I could afford. If that meant waiting until I could change policies (assuming my health would allow), I'd do that. I don't know your financial situation, but if you're reasonably well off, are you really going to risk your health and mobility for an extra $1,000/month for a year? I think this is where you can be penny wise and pound foolish. Also, maybe the penalty for going out of network isn't too bad. One combination that might work is if the surgeon is out of network and the hospital is in network, you might pay the physician fee out of pocket.
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