Pat wrote:
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Is bunion surgery normally done by a podiatrist or an orthopedic surgeon? I have a bunion on my left foot that has caused a hammer toe on my second toe and significant pain which initially presented like a neuroma between the second and third toes. The pain has been considerable and is worsening now that the hammer toe has appeared. Podiatrist says surgery is the only way to correct both problems.
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Both podiatrist and orthopedists perform bunion surgeries, and there are both good and not-so-good surgeons among both groups. Although there are some orthopedic surgeons who now specialize in surgery of the foot, ALL podiatrists who do surgery specialize in surgery of the foot. So, assuming equal surgical loads, unless you select an orthopedist who does only foot surgery, it is likely that a podiatrist is more experienced in surgery for the correction of bunions, hammertoes and neuromata of the feet than would be the averave orthopedic surgeon.
I would agree with your podiatrist that the only effective and hopefully permanent method of correction of bunions and hammertoes, and for the most part, neuromata of the feet, is surgical.
Whichever type of specialist you decide upon to perform your surgery, the most important decision is not podiatrist vs orthopedist, but the qualifications of the particular doctor you select.
Here's what I would look for in a podiatric surgeon:
1. Real board certification . . There is ONLY ONE recognized surgical board in podiatric medicine, and that is the ABPS (American Board of Podiatric Surgery). Don't be impressed by all the other organizations which the doctor claims to be a member of or even certified by. If your surgeon is board certified by the ABPS he/she surely will have a certificate to that effect pridefully displayed in the office.
2. Hospital privileges at a well-respected hospital in your area. State Licensing Boards, which grant podiatric graduates license to practice within its state, really demand insufficient proof that the doctor is a good one. In fact, most licenses are granted prior to the private practice of the doctor, and unless he/she had done or subsequently does something R E A L Y bad, and does it often enough, and has been reported for same, the doctor will remain in good standing. Hospital privileges offer at least two advantages. Firstly, hospitals have a vested interest (financial and reputation) in providing good care. To obtain privileges on a hospital staff, a doctor must supply the credential committee with proof of adequate training, and an essentially clean record in practice. Then the individual department "credentials" the individual with a process know as "delineation of privileges," and so specifies which procedures he/she is qualified to perform, frequently based on actual surgical assessment by a qualified staff member. (Not all surgeons on a hospital staff will necessarily be permitted to perform all procedures for which he/she is legally allowed). Also, when surgery is performed in a hospital setting, rather than behind the walls of an office, the surgeon and his/her technical abilities are on display for peers to see, and they can't very easily or for very long be swept under the rug as can easily be done in the office.
3. Find out to what degree of respect your surgeon is held within the local medical community . . Not by his/her friends, but by his/her peers. Many states keep a database, available to the public, where the doctor's malpractice and disciplinary record may be checked.
4. The very last place to go is patient references, as most patients have no way of assessing the skills of their doctors. If they had successful surgery, he/she must be good, and if not, he/she must not be good. But more importantly, since most folks do not know what makes a good or bad doctor, they rate the personality, and when a surgeon is coming at your body parts with a sharp knife, personality is absolutely no consideration.
Surgery, as well as all medical treatments, always has the potential for failure and undesirable results. Part of being a good surgeon is in knowing how and when to deal effectively with the untoward event which do occur. There is no one best method for most surgeries, as not all similarly named conditions are exactly alike, and so procedures should be tailored to the individual case. That's another skill necessary for the good surgeon . . knowing what needs to be done and doing it effectively.
Be certain to have a talk with your surgeon prior to the procedure in which he/she answers ALL of your questions, gives you an idea of what he/she expects the disability and recovery period to be and what the success/complication/failure rate has been in his/her personal experience. If your surgeon doesn't have the time to talk with you prior to surgery, God help you if you have a problem afterward.
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