Author: Dr. David S. Wander
Date: 11/11/2005 2:46 pm PDT
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I have not had the opportunity to read your post regarding MIS surgeons. Initially, when I started practice in Philadelphia, there was a doctor performing MIS surgery on every patient that was breathing. (I do believe that MIS may have it's place for a small exostosis on a phalanx, etc.) He was promising patients that they could have their bunions removed at lunch time and be at work that afternoon. Economically it was a nightmare for me, because that patient came into my office with an IM angle of 18 degrees, and I was performing a proximal osteotomy with internal fixation, below knee casting and non weightbearing for 6-8 weeks. Therefore, which surgeon do you think the patient chose? This is exactly the point you discussed regarding patients having to take some responsibility for their own care. This is a great example of how uneducated consumers ended up with horrific results. Fortunately, but unfortunately most of these patients ultimately ended up in my office for revisional surgery. In my 2nd year of practice I probably did more revisional surgery due to this other doctor, than most doctors perform in 10 years. This is when I formed my philosophy to educate my patients regarding treatment options, risks, complications, expected outcomes, etc. I have found that an educated patient has a more uneventful post operative course because his/her postop expectations are realistic and clear. You are correct, patients really do need to take some more responsibility regarding physician selection. Unfortunately, I believe people spend more time deciding what color his/her car will be than the doctor he/she chooses. |
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