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What type of doctor-is "big" the best

Kris-NYKKris-NY Posts: 2,207
edited 06/11/2012 - 8:44 AM in Back Surgery and Neck Surgery
Last Friday I went to an orthosurgeon for a consult. This guy is head of orthosurgery at one of the top hospitals in NYC. The experience was very different from my other doctors who are all considered top doctors on Long Island (suburb of NYC). First I waited almost 2 hours to be called in. Then I waited in a room for a half hour. Then the surgeons chief resident came in. Nice guy who took my history and did a very complete exam. He ordered an xray and then came back. Then he took my films and cd of MRI and CT and said he would review them with the doc. They came back 15 mins later(alittle quick for 2 MRI, 2 CT and xrays) and the doctor pronounced he didn't see anything that was causing my pain. Good Bye

For the past two days I've been thinking about this experience. It's making me question whether going for the "big name doctor" is really the best thing. In my world going to NYC is the ultimate in treatment. But we have an excellent hospital network in my area.

My surgeon is head of neurosurgery at this hospital. His office is very efficiently run. I never wait more than 15 minutes in the waiting room and then again never that long in the exam room. I talk to him not an assistant. And he goes over the reports and films or cd right there with me.

So my question for everyone is "what do you think? Big name doc or well-respected local?"


  • I've had it happen both ways. When I went for my first appointment in NYC I had a afternoon appointment and we waited for about 1/2 hour to get into the exam room. A assistant came in and did a brief exam and also went over my history. She said the doctor was reviewing the films in another room, one that had an area that he could put up a bunch of fims at once. He came in about 15 minutes after the assistant left and proceeded to do another exam and put the relavant fims up so as he was talking to us we could see what was wrong. I was happy with the first experience and also with visits during the hospital stay and follow up visits.

    I have had had 3 surgerys, by 2 different surgeons, locally, over the years and almost always the wait times were long. For one of them I would of been happy for only a 2 hour wait time. One of these surgeons had an assitant that did most everything and the other surgeon didn't have an assistant so I guess it goes both ways. It is a crap shoot that is for sure. There is nothing wrong with a local surgeon if they fit your need. I have heard of your complaint at one of the big NYC spine hospitals before. They get overbooked just like the airlines and some things end up suffering. Sounds like you are looking for the cause of some problems that no one has been able to come up with a reason. My suggestion---keep looking. It has been my experience that doctors that are the head of anything tend to be short and somewhat arragant.

  • Howdy Kris,

    Both my Ortho (not a spine Ortho) and my NS are tops in their fields down here in South Florida. My Ortho manages his time/patients horribly, but he is good, very good. :) My NS manages time very well, no assistants to be pre-screened with, and he views the films in front of me, and then explains what he sees' or doesn't see, and he is very good. My NS feels my nerve issues of late are out of his area of expertise, and as such referred me back to a Neurologist who is known as a trouble shooter - be calling Monday for an appointment. I gained even more respect for my NS after that appointment because he didn't let his ego get in front of my health issues. :)

    I find that there seem to be 2 times a doctor 'really sees' you'...on the first visit, and then later as a rep-or is established. In between can be a crap shoot! That's been my experience at least of late.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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  • SpineAZSpineAZ WiscPosts: 1,084
    My dad ran into similar stuff at the U of Michigan in seeking out the best of the best. I've been lucky to find well qualified orthopedic spine surgeons that aren't leading the field at a university or via publications, but are known to be very good at what they do.

    But, with any orthopedic surgeon, the wait can be long. I always get the first appointment of the day even if i need to be there at 7am. With my spine doc and my knee doc I always plan for some waiting room time. Then they take you to the exam room and you feel like "he'll be in soon" and it can be a 30-45 minute wait for the resident or nurse or medical assistant.

    You do want to find an excellent doctor, but not all the excellent doctors are at university hospitals or running a practice such that they never see you, the resident does. For me I like the surgeon to know me and recognize me the day of surgery, but also be excellent!
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • I don't think it matters if they are big or not. It's how they run their "shop".

    I've experienced both.
    Oddly, my current surgeon (neurosurgeon) is at a very large hospital, shares his waiting area which if you didn't know better, seems like an ER or Urgent care center. I almost walked out. But to my surprise, they are ALWAYS on time and if I show up early, they generally take me early...I love them!

    My last surgeon was a partner practice (2 of them), they were horrendous. I never said anything b/c they never asked and I never know if I'll need them again. But I'd show up 15 min early per request, wait in the waiting room for at least an hour if not more...then they'd bring me into a hot room and I'd wait again. I would get so annoyed b/c my time is also valuable.

    However, when I was searching for a new doctor, I found both experiences....seems if you hit them on a busy day, they try to squeeze in emergency/urgent cases so you can end up waiting. I try very hard not to get too upset but it's hard.

    My only thing is that when I see the doctor, I don't want to be rushed. But sounds like you were.

    At the end of the day, the doctor has to want you to be his patient...if he treats you so "cold", it's not a good match.
  • MetalneckMetalneck The Island of Misfit toysPosts: 1,778
    I believe that I have one regret ... that I didn't get myself up to the place in the twin cities that rymes with day-o.

    It was suggested by MANY family and friends but I figured oh heck I'm in Chicago and there must be just great surgeons around here. I do believe that my Orthopedic surgeon (yes fellowship trained) did a fantastic job with the mess he had to work with ... the left overs and failure of a highly respected neurosurgeon - who started out as a "business major" before switching to Neurosurgery.

    Funny the things you learn about your doctors after you have had a less than "optimal outcome" with their approach and skill set.

    My suggestion is to get their stats on infection rates, surgical outcomes, hospital affiliations, previous lawsuits. Funny that my SSD Attorney said that many of his clients had surgery by the Neurosurgeon that did my first 3 level ACDF.

    So if you want to know who NOT to go to ... maybe ask the best SSD Attorney in your area?

    Kinda of an opposite anwser - but something to consider.

    Keeping all of us in my thoughts and prayers,

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  • Dave did you ever consider malpractice? I know I still have alot to find out but from what I learned last week I am seriously wondering if this is malpractice. From what I have hear it is almost impossible to win a malpractice case. And then there is the stigma and rep that will preceed you if you need more surgery.

    Just wondering.
  • MetalneckMetalneck The Island of Misfit toysPosts: 1,778
    The "standard of care" that was provided was not outside of the bounds of normal treatment.

    I (on the other hand) can think of MULTIPLE things that I did wrong, that assisted in the outcome of my first surgery.

    Kinda like that old saying ... when you point your finger ... there are three pointing back.

    Unless they leave a hemostat or wrist watch inside of you - malpractice IS a very exceptional situation.
    You hear about the big wins ... you rarely hear about the multiple cases that are settled for little $ or simply dismissed for lack of grounds based on standard of care. And your very right ... go down that path and go luck ever having another surgeon agree to ever touch you again.

    I blame my outcome more on myself, than my first surgeon.

    Honest and humble today?

  • Kris, I really dont have anything to offer as an answer to your question just that I am thinking of you and hope you find the right doctor for your situation. Like Brenda I have an excellent ns and neurologist here florida, I cant say enough about both of them. They have done nothing but their best for me and waiting time is not bad. I havent seen an assistant at all. Just wanted to let you know how disappointed I am for you, I know when we seek answers and have waited for that appointment that can be devastating. p.s. I have a cat that looks just like yours! Fat Louie is his name, Lela
  • about the big names, but I'd head for the major teaching hospital in your area. The hospital near me (teaching one) really sucked, but the surgeon was fabulous and did a good job of patching me up. Hospital dang near killed me, but I made it. I think docs at teaching/research hospitals are more likely to look for the root of the problem and help you out, instead of just pronouncing that there is nothing wrong with you.

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • After seeing so many doctors in my life there is one thing that always sticks with me. If the doctor is using a PA I am not in for that. My insurance pays the same and they don't know the difference but there is a reason one is a PA and one is the actual doctor. After surgery I want the one who knows what they saw not the one reading the notes from the surgery. Now I am not making a bad statement against PA's, but I researched the doctor not the PA. The surgeon I currently use doesn't use them and he reads his own films. Is that right or wrong don't know just works for me. I am happy he knows my case very well and we don't have to discuss or do the detail thing about it as he is up to speed on it. He has actually send me out for testing and nerve blocks and called those doctors himself to make sure what he wants is done. Now if i ever called their would I get him on the phone, nope. His nurses return all calls and if it is something to be concerned about, his answer is he can't dx over the phone so come in. I think sometimes doctors and patients just don't mix well with individual personalities. Sure that shouldn't come in play but it does they are human as we are. So while one person may have had a great encounter and yours not so good, depends on the day of the week what is going on and lots of other issues. But the great thing is you can always keep searching for someone who fits your needs.
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