When it comes to selecting a surgeon, I'll take skill over personality anytime. But the $64,000 question is - how do you assess a surgeon's skill?
To help you navigate the murky waters of getting the real scoop on your surgeon, here are several little known and highly effective ways to find out about your surgeon's skills and expertise:
Talk to the nurses
The nurses see the surgeon's results - they see the successes and they see the mistakes - and they know the difference.
Ask to speak to the Nursing Director. Let him or her know you have questions for the operating room (OR) nursing staff and anesthesia personnel, and ask for help gaining access to them. Also ask to speak to nurses who work on the floor where surgeon's patients usually go after surgery (they see the recovery experience of that surgeon's patients vs. other surgeon's patients).
Once you have gained access to the right people, ask them specific questions:
- If you needed this surgery, who would you have do it?
- Would you send one of your parent's to this surgeon?
- Can you share a great success story about this surgeon?
Of course the nurses usually won't come right out and say, "That surgeon is terrible." But you can usually pick up on their overall opinion of the surgeon through your discussion anyway (e.g. by what they don't say or with their facial expressions).
For example, if the nurse says, "I sent my dad to him" that's about the highest praise there is. Conversely, if the nurse says, "He's such a nice guy" but declines to comment on his surgical skills, that is a red flag.
If you're still not sure, you can ask to speak with the Risk Manager of the hospital, who is usually a supervisory nurse. Again, he or she will give you just basics but the tone in which he or she talks with you might allow you to pick up on subtleties.
Get specific references
Ask for references from three patients, but don't ask the surgeon for these. Ask the physician who referred you to the surgeon (this will typically be your primary care physician). That way you're more likely to get a balanced view. Then, provided those patients give the surgeon good marks, ask your surgeon for two more references, and this time ask for references only from patients who have had your specific surgery for the same diagnosis.
For those of you who are wondering, yes, you can ask your doctor for references from other patients. A good surgeon will be happy to give you references and does this sort of thing all the time. A good surgeon will have plenty of patients who are happy to serve as references. And a good surgeon knows that if you're confident about your decision to have surgery and your choice of surgeon, then you'll do better after the surgery.
You really can't do too much of this. If you have any friends who work in the healthcare field, see if they can find out about your surgeon. The healthcare universe is actually quite small when it comes to surgeons, and often it just takes a couple phone calls for someone who works in health care to find out about the reputation of a surgeon.
Crowdsourcing on the internet
Internet sites like RateMD.com, HealthGrades.com, and Vitals.com are tapping into the collective wisdom of thousands of patients, allowing them to rank and rate physicians based on their individual experiences.
There are several limitations to this, however:
- These sites don't have that much participation from patients. Many physicians only have one or two ratings.
- It's human nature for mainly the dissatisfied patients to go online and complain - the ones who were happy with their surgery typically don't comment on these sites.
It doesn't hurt to check to see what other people are saying about the surgeon in question, but be sure to take the comments with a grain of salt.
Outcomes based rankings
Consumer Reports and Medicare are starting to score doctors on their actual outcomes. Consumer Reports recently launched ratings of surgeons based on their heart bypass outcomes, but more specialties are sure to follow.
Medicare also rates physicians based on outcomes, but if your surgeon does not take Medicare he or she will not be included.
Also, consider doing a background check (using Doctor Background Check or MD Nationwide) to review any history of malpractice or to discover if the surgeon has been subject to any disciplinary actions.
Know the answers to some questions
When you ask your surgeon questions, make sure you have an opinion about the correct answer to some of the questions so that, even though you don't have an MD or DO, at least you will be able to gauge the credibility of some of their answers. To do this, look up everything you can about your surgery - such as on the Spinal Fusion and Back Surgery sections of this site).
Use the knowledge you gain as a basis for an interview with your surgeon. For example, if your surgeon is recommending an ALIF for lumbar degenerative disc disease, look up the principal risks of this surgery on Spine-health.com and then ask the surgeon what they are. If he or she fails to mention one or several of the main risks, this is a red flag.
Board certification and state licenses
At the very least, confirm that he or she is board certified or board eligible in his or her specialty by visiting American Board of Medical Specialties. Visit Federation of State Medical Boards to make sure he or she is licensed in the state.
Also read as much advice as you can on how to select a surgeon, such as 38 Questions to Ask Your Surgeon Before Having Back Surgery and How to Select a Spine Surgeon
All of the above takes time, but when you consider the magnitude of the potential risks and the potential upside of having surgery, then it is definitely worth the time and effort.
Special thanks to the collective insights and experiences of Spine-health's active and vibrant Pain Forums for contributing most of the above points.