It is estimated that over 39,000 orthopaedic surgeons now operate in the US alone (according to the American Academy of Orthopaedic Surgeons). So how do you even begin to choose an orthopaedic surgeon for your particular shoulder surgery?
After all, you should choose your orthopaedic surgeon as carefully as you choose your spouse! By working through the points in this chapter, you will be able to narrow your choice to one or two surgeons.
In your final choice, you must develop a strong working relationship with your shoulder surgeon and be confident of his/her abilities. Anxiety, distress, and lack of confidence in the procedure have all been shown to affect the successful outcome of elective orthopaedic surgery.
Now is the time to start your progress to a highly successful outcome by choosing the orthopaedic surgeon who is right for you.
Referrals
Your referring general practitioner or primary health physician can recommend local orthopaedic surgeons who have expertise in shoulder surgery, particularly your condition and procedure.
Physical therapists with special expertise in rehabilitating shoulders post operatively will have an intimate knowledge of which shoulder orthopaedic surgeons have training and experience in your surgical procedure.
Other health professionals with shoulder experience may also be able to recommend surgeons.
Friends and relatives are often happy to recommend a surgeon they have had experience with, but be aware that well-meaning advice can lead you astray. If a particular surgeon is recommended, make sure the friend or relative has had the same or similar surgery. You need to compare oranges with oranges, not oranges with apples!
Online Research
Your surgeon’s website & other websites (hospitals, professional associations) can provide a wealth of useful information:
Where, when and how your surgeon was educated to achieve his qualifications as a surgeon.
How is he qualified to be a surgeon? In the US, is he “Board Certified”? In other countries, is he a member of the Orthopaedic Surgeon’s professional body?
Experience—does your surgeon regularly perform the type of shoulder surgery that you need?
Does your surgeon have experience and training in the latest technology and techniques for this type of surgery?
Gender—it is important to feel comfortable with the surgeon’s gender as you will need to openly discuss personal information.
Hospital(s)
Which hospitals your surgeon operates at can be a deciding factor in your choice of surgeon.
The convenience of a local hospital may be important to you.
Also consider the reputation of the hospital, and ancillary facilities and services offered, such as physical therapy.
Some hospitals offer residential post-operative rehabilitation, which can be important if you have no at-home support from family or friends.
Call the hospital directly to enquire about costs of the procedure and all ancillary costs.
Fees vs Insurance Coverage
Contact your health insurer before approaching an orthopaedic surgeon, as there will most likely be out-of-pocket expenses. The choice of surgeon (and hospital) may minimise these expenses, but still consider the surgeon’s qualifications, experience, and hospital reputation before finalising your choice.
The Initial Consultation
Be Prepared
This is the stage of the process that will determine the quality of relationship you build with the orthopaedic surgeon.
Building this relationship will be easier if you go to this initial consultation well-prepared. By that I mean do your research (read this book!) and have some understanding of your condition.
Go armed with a list of questions for the orthopaedic surgeon (see the chapter What You Need to Know from Your Orthopaedic Surgeon).
It might also find it helpful to write out the course of the history of your shoulder problem in a simple bullet list.
Keep these points concise and pertinent to your shoulder problem:
List the aggravating factors and the level of pain.
List the crucial points of the history of the shoulder in chronological order.
List the treatments that you have had for the shoulder, their dates and effectiveness.
Arriving at this initial consultation well-prepared allows more time for answers to your list of questions.
Surgeon’s Communication Style
During this initial consultation, the surgeon’s communication skills and style will become apparent. If you find that you are comfortable with the style, and communication between you comes easily, then you have the solid basis of a working relationship.
However, you are not looking for a new friend, but a competent professional who can communicate clearly with you.
Service level by other staff
Another factor that can determine whether the entire process (the lead up to your surgery, the surgery itself and your post-operative period) is smooth and stress free, is the level of service provided by the surgeon’s ancillary staff, and their efficiency.
Your experience with these staff members before and after this initial consultation should give you the clues you need to assess this.
Answers to your questions
It will be difficult after this initial consultation to remember all the answers that the surgeon has given you to your questions.
I advise patients to take a friend or family member to listen to these answers and to take notes where appropriate. Having someone to confer with after the initial consultation also reduces the stress of the consultation itself, as you do not have to remember every single thing that the surgeon said.
A Second Opinion?
If, at the end of this first consultation, you are not completely confident in your first choice of shoulder surgeon, keep looking. Your confidence and trust in your surgeon will impact on your surgery outcome.