The following editorial was submitted by John Masonis, MD, to The Charlotte Observer. It appeared in print and online on July 2, 2007.
Each year, U.S. physicians perform more than 300,000 total knee replacement procedures, more than 90 percent of which allow patients to experience a dramatic reduction in pain and a significant improvement in everyday quality of life. However, approximately 8 percent of patients are not “satisfied” with their outcomes, and about 2 percent of knee replacements do result in serious complications.
This statistic is a pointed reminder that there are risks associated with surgery, and that before any type of procedure – orthopedic or otherwise – patients should fully understand potential complications, expected length and path of recovery (including physical therapy), and possible physical limitations once all is said and done.
Though many patients do carefully weigh the pros and cons of a major surgery like a total joint replacement before undergoing the procedure, too few of them pay adequate attention to their doctor’s experience in the relevant specialty.
Most individuals would never buy a car or home without thoroughly researching every aspect of the purchase; nor would they entrust the safety of their children to just any caregiver without first performing a background or reference check. Selecting a surgeon should be no different. Here are four questions every patient should ask to ensure they’ve selected the right surgeon to perform their surgery:
Is my doctor board-certified in his/her chosen specialty? While all physicians must be licensed by the American Medical Association in order to practice medicine, not all are board-certified by their particular specialty associations, such as the American Academy of Orthopaedic Surgeons.
What is my doctor’s experience with my particular surgery, including number of procedures performed annually, outcomes and complication rates? Research has proven that surgeons and hospitals that specialize in a particular surgery or procedure have statistically superior outcomes and lower complication rates.
Is my doctor subspecialty fellowship-trained? After residency training, some physicians choose to pursue an additional one or two years of in-depth specialty training under a top specialist in their chosen field, such as hip, knee, shoulder, or spine surgery.
How involved is my doctor in new research and continuing education in his or her area of expertise? While all physicians are required by the American Medical Association to accrue continuing education units in order to remain licensed, some dedicate additional time to research that can potentially improve patient outcomes in their respective specialties. For example, physicians from the OrthoCarolina Hip & Knee Center recently completed a study on pain control during rehabilitation from total knee replacements, which was presented at the annual meeting of the American Academy of Orthopaedic Surgeons for the benefit of orthopedic colleagues and their patients across the country.
The decision to undergo surgery is never without its risks – however rare – and it’s important to note that pre-existing conditions or complications play a large role in the ultimate success or failure of a procedure. That being said, while even the most skilled surgeons can’t fix the impossible, patients can reduce the likelihood of encountering post-surgical surprises or complications by being equally informed about both their physicians and their prospective procedures before their surgeries take place.
Dr. John Masonis is a fellowship-trained, board-certified hip and knee specialist at OrthoCarolina.
