Sunday, September 24, 2017


Surgery!     .  You may already be a surgeon's office.  You called  because something is very wrong. .   The surgeon who is talking to you now may already have a plan.     .He (or she) starts talking about what will happen.  This can make us think it's decided. But we must ask our questions, answer some of his, and be prepared

 To say that's all we can handle for today
 To tell him we will want a second opinion.  
To stand up, thank him and 
Walk out.

Surgery for most is permanent and risky.  Do-Overs do not fix what's been done, and we won't get 0ur money back. If you don't read all this, please at least read the last section.

A recent AARP  article "PICK THE RIGHT SURGEON subtitled Act as if your you choice is a life or death decision--because often, it is."  convinced me to work on this.  The writer, Linda Marsa emphasizes that any thing with knives can have "life-threatening complications."

Some state medical groups police their doctors.  My state medical board has punished some.  But doctors don't always police themselves.   A pub-med article lately said some doctors don't reveal bad doctors because they think... nothing would be done about it, or there's a "fear of retribution."

The good news: her quote from ProPublica:

  "One group of 756 highly active surgeons
 didn't have a single complication over five years."

Later Marsa suggests such great results should happen oftener, quotes a study for one kind of surgery, death rates 4xhigher for those who performed fewest of a certain surgery compared to those who performed the most.  (Doctors have even tweeted that doing a certain number of times counts.)

Also she ssays MBJ finds that specializing in one demanding complex surgery type "significantly cut the risk of complications and mortality."  So we ask a lot of questions like: how often, and is it your specialty?

She also has other places to search:

For credentials, the Federation of State Medical Boards has  Click Consumer Resources
     For reprimands -for $9 they will give you disciplinary history
     Some state med boards have doctor profiles
For  surgical board certification, certification, or call: 866-ASK-ASMS.
For specific errors, Consumers Checkbook or Pro Publica.  Remember some doctors take on very difficult patients which may affect their success numbers, while others take the easy ones. 

MD Referrals:  With the spine surgery - my primary doctor  knew everybody. I took his suggestion, and the spine has been great.  But another time I didn't take his first choice because I had met that surgeon and didn't like him. And my rule is:

Nobody I don't like is cutting me!  Period. 

 If you are new in town, you may not even have a doctor or a few friends to ask for recommendations.  If you're working, there might be someone you could cautiously ask.
A co-worker led me to  my beloved L.A. doctor.

 At the dentist, in the mammography place, in the drug store, keep your ears open:  I was lying on a gurney in the hospital hall once when a nurse saw the ticket on my gurney: Ooh!  You got Dr. G.  He does fancy!   Yes, Marsa admits - hospitals don't always kick out bad surgeons.

She suggests "Identify surgeons approved by your insurer."  I haven't tried that.

So it is possible to get a good one.  One more suggestion:

The hospital referred me to the solo lumpectomy surgeon. He did a good job, answered questions, told me I didn't have to do anything further, showed me my path report, gave me referrals including the oncologist I love.

Once you've got a name or three,  Do Not Skip This Section.  This is where we pin down the surgery facts way before our Yes or No.

Ask and persist until you get answers:

Can this be done with minimally invasive surgery - like laparoscopy or...?
What percentage of these involve open surgery?
What percentage of these have complications?
 Is hospitalization involved?
Do you specialize in this surgery? 
How many of these have you done?
What are my risks?  And above all...


Then as Dr. Cedrek McFadden's Tweeted:
"If no common ground or respect is found, move on." @cedrekmd

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