Posted on February 17, 2015 Dr. Christian Subbio
The Best Kept Secret In Choosing A Surgeon?
It’s inevitable: sooner or later there comes a time in our lives when we, or a loved one, will need surgery. The very though of it can be understandably terrifying; after all, unless one works in a hospital (or more accurately, in an operating room), how can one ever fully trust that he/she is picking the “right surgeon for the job”?
Some patients will, in a knee-jerk reaction, run to the nearest prestigious university, fully assuming that an ivory-league pedigree stamp guarantees top notch surgical technique and reliable results. If only that were true. While many of those surgeons on staff at big-name universities are truly authorities in their field, there are just as many there whose academic resume far outweighs their real-life surgical technique and skills. Far too often, a surgeon can gain national renown via extensive research, publishing in journals, and generally focusing on academic advancement without truly distinguishing him/herself as a comparably excellent technician. Ask any surgeon; he or she can easily call to mind observing a “big name in the field” who operated surprisingly sloppily or in a hurry to get to the next meeting. Simply put, an ivory-league diploma or academic position does not guarantee an excellent result by any stretch of the imagination. Sure, when one is afflicted with a condition or problem which is rare, it makes the most sense to travel to these highly-specialized centers where experience and numbers count. But for anything else, there simply is no guarantee that you or your loved one will end up in gifted hands.
How about magazines? We’ve all picked up a copy of an in-flight magazine only to stumble across ads for America’s “Top Docs”. Or thumbed through our local periodical’s “Top Docs” Issue while in the waiting room. Or perhaps received an obscure magazine in the mail seemingly filled with reliable recommendations for physicians. The important thing too remember when considering any of these publications: Where do the ratings come from? Unfortunately, many of these periodicals are nothing more than glorified paid-advertisements which carry no real weight when it comes to anything clinical. Some more respectable mags arrive at their conclusions based on rating by the surgeons peers & colleagues. While certainly more appropriate, one must wonder how many of these votes are influenced by actual time spent operating together as opposed to academic pedigree or research publications (see above). Probably the most reliable “best of” lists are tallied by patient votes. But, even these are too often influenced by a friendly doc’s bedside manner, or an aggressive “vote for me” campaign. So how about…..
Online reviews? Sure, we can more easily than ever, resort to the all-knowing Google search, in hopes of finding a surgeon with superb online ratings. But, like anything on the internet, these rating must be considered carefully. Some less-scrupulous providers can hire reputation management firms to falsely generate scores of positive reviews. And, like explained above, a friendly and likable surgeon can often generate positive grades without their patients ever realizing that the care they received could potentially be substandard. Finally, some unfortunate docs will sometimes resort to false negative review about competitors in order to gain a dubious advantage.
So how can one ever know which surgeons truly are masters of their craft?
ASK AN OR NURSE OR TECH!
No one knows better how a surgeon, well, operates in the OR. With many of these assistants having spent over twenty years in the company of operating surgeons, the nurses and techs are often highly tuned to which providers “make the cut” better than others. Go ahead, ask any operating room nurse which surgeons are “slick” as opposed to “sloppy”. Chances are, he/she’ll have any answer for you before you can say “scalpel please”. Ask any surgical technician which specialist knows how to maintain their cool when things aren’t going as planned, they’ll have an answer without batting an eye. More so than any colleague or patient, these assistants are there on the front lines, watching the surgeon perform every aspect of the procedure. Even without necessarily knowing the technical steps of a given operation, one can easily tell the grace with which a surgeon’s hands dance, and the efficiency with which sutures are tied. One does not need years of medical school to be able to tell which docs keep their surgical fields clean and neat, and those whose procedures resemble more of a medieval blood-letting. After all, a neatly-sutured incision line versus a hastily-stapled one is as obvious to a medical professional as it is to an accountant. True, OR staff can be influenced by a charming surgeon as much as a patient, but by and large this will weigh less heavily on a recommendation based on having actually observed said surgeon at work.
ASK A RESIDENT!
In addition to the above advantages, senior surgical residents have the added benefit of understanding some of the decision making behind the procedure, and technical details that others might not be privy to. Senior residents have often spent years scrubbing cases with every surgical attending at that particular institution, and have “sampled” the various techniques and skill levels of each. Furthermore, residents spend countless hours rounding with surgeons in the wards and in their offices. They have a good sense for the quality of his/her medical decision-making and bedside manner as well.
So, in the end, rest assured that every OR nurse, OR technician, and surgical resident has one or two “favorites” surgeons. These are the surgeons to whom they would recommend their own family and friends and loved ones. If you truly want the “inside scoop” on whose hands are the most gifted, on whose hands you should entrust the care of your loved ones, look no further than the OR lounge.