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Saturday, October 21, 2006

Having surgery - which doctor is best?

Any surgery, no matter how minor, carries a degree of risk. In fact, the most appalling medical balls-up I have ever encountered happened during an operation to remove a small mole from the cheek of a fit young man. After spending a year or so in an old people's nursing home as a near vegetable, he finally died the most agonising of deaths.

Choose your surgeon carefully - you can't trade in your body if something goes wrong!
  • Choose a Dr who is at the peak of his/her professional powers: between 35 and 60 years of age is a good rule of thumb. Stay away from the brilliant young ones and the doddery old ones who are long past retirement.
  • Be wary of the foreign trained Dr. I recall a Dr friend telling me of his concern when he noticed a foreign trained colleague taking a quick look through a text book prior to undertaking a potentially risky procedure!
  • Get a specialist surgeon and not a general one. If it is a knee op, then get a surgeon that specialises in these; if it is a back op, then go to a back specialist
  • Be wary of the latest technique: if the surgeon has not done at least 50 of these "new" procedures, don't volunteer to be a Training Dummy.
  • Be wary of having it done in a training hospital: the specialist might be tempted to go on an ego trip in front of the students while poking about your insides; worse still, one of the students might be allowed to "have a go" on you.
  • Private is not necessarily the best. The same surgeons that operate in the public system often work privately. Private hospitals may not be properly equipped for emergencies, relying on emergency transfer to the better equipped public hospital. This is what happened to the man with the mole, with the subsequent delays causing irreparable harm.
Find out the following:
  • Is there a problem with antibiotic resistant drugs in the hospital at which the surgery is planned? These awful bugs are a growing problem in hospitals, despite attempts to keep this quiet. Choose a hospital that is certified free of these bugs.
  • Who is the surgeon with the lowest failure rate? Ask people who have had the procedure. Speak to therapists like physiotherapists, occupational therapists, osteopaths and chiropractors about who they think is best for a particular procedure. If you can get it out of them; ask who to avoid.
Take your time. Take your time!
Is the operation really necessary? Are you being recruited as un-witting high profit contract padding? Here is NZ much orthopaedic surgery is unnecessary; but happens because of the Government contract purchasing of millions and millions of dollars worth of surgery for hips, knees etc. These production line contracts are made all the more profitable when the more costly "necessary" ones are padded out by the many operations that need never happen and which would be better managed by non-surgical methods.
If the answer is that it can wait, then why not wait? Procedures improve, new ones are developed and, surprise - surprise! Things often get better of their own accord. Especially if you have been following my exercise, nutrition and lifestyle advice.

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