Knee Replacement 3: Choosing a Surgeon
Not all surgeons operate equally, and the one you choose is very important. For most of us, this surgery will be the most impactful medical procedure of our lives. Full stop. I know, I know, you have friends who are telling you that it’s no big deal, just get on with it. Don’t listen to them. Their anecdotes are likely from others who’ve forgotten the details, the sleepless nights, the suffering. I can’t forget because I’m writing this from the middle of it—60 days out from my first knee replacement and 18 days out from my second installation—and still dealing with daily pain.
Of course, everyone is different, and while I allow that you may not have the travails that I’ve endured, I think it’s best not to minimize the experience; joint replacement surgery is a big deal. And one of the key predictors of success is who you choose to do yours. My process began with some simple questions:
• Who is the best in the area?
By talking to friends who’d had knee replacement surgery and doing some simple searches, I made a preliminary list.
• Does my insurance cover this surgeon and their facility?
I got on my insurance company’s website and cross-checked.
• Can I get in to see them?
I messed with online appointment services, but those mostly sucked, so I just picked up the phone and called for an initial consultation. If I couldn’t make it through their phone tree, I crossed them off the list. Amazingly, I still had a list at the end of this exercise.
The next bullet on my list was the most important: the human connection with a doctor.
There was probably a time when it didn’t feel like every company—from the cable provider to the gym (don’t get me started on Planet Fitness) to the phone company, to insurance providers and, by default, most medical providers—was out to screw me, but I don’t remember it clearly. It’s not that people in the medical profession aren’t well-intentioned; it’s that the healthcare system is optimized around operational efficiency, financial returns, and risk mitigation.
Positive patient experiences are a shimmering chimera, a beautiful yet elusive notion.
The only bulwark against this callous reality is the human. Does your doctor and their staff care about you? If they don’t, and everything goes perfectly, you will still probably be fine. But if things get complicated in any way, you will want someone you can talk to about it. You don’t have to be best friends with your doctor, but don’t choose one that you couldn’t stand to have lunch. Ask yourself this simple question: when things don’t go right, will this person care enough about me to call back on a Saturday morning when I’m writhing in pain and need to change medications or on a Friday night when I’m in the emergency room with a plunging hematocrit? There’s a reason I chose those two examples. We’ll get to that later.
One of my hockey buddies, who is now skating smoothly on his titanium knee, had recommended Park City Hospital and the orthopedist who performed his miracle. I got through the phone tree and secured an appointment. Showing up at the check-in desk early, I was upbeat and proud to have finally made the decision to get both knees replaced. I felt like a new tomorrow is just around the corner.
And you are? Asks the woman behind the check-in desk.
I give her my name, DOB, address, and all the rest of it.
She grunts, hands me a clipboard, and points toward some chairs with a pen.
Fill these out before we can think about seeing you, she says.
She says it in a way that makes it clear that they really do not want to, nor need to, see me.
So begins the first hour of a relationship with a team that will be sawing both of my legs off and reconstructing them. The next hour involves X-rays, which I had done a month before, but apparently those were captive in another hospital with sharing issues. Hour three involves finally meeting with the esteemed surgeon, whom I will call Sawzall.
Yep, you’ve got some screwed up knees, he says, looking at the transparencies on the X-ray viewer.
I stare at the X-rays and start to explain—I was a mogul skier, a collegiate hockey player, and lately there’ve been the dirt bikes…
When I look over, however, I notice he’s looking down. At his phone. He couldn’t care less about what I’m saying. Granted, most people who walk into the Park City Ortho department think they are special. It’s a town overbrimming with entitlement. And in the doctor’s defense, the stories all sound pretty much the same: skiers, unique situation, worn-out parts… but could you maybe feign some interest?
So, you think it’s advisable to have two knee replacements done? I ask.
Why else would you be here? Sawzall replies as he turns toward the door.
Yep, I say.
We’ll get you scheduled as soon as possible.
The door closes.
Nope, I think.
There’s got to be someone better.
Among the people I spend time with, there’s no shortage of opportunities to visit hospitals. Soon after the Park City Hospital visit, I’m at The Orthopedic Surgery Hospital (TOSH is how the facility is known) in Murray, Utah. Today I’m not the patient; my daughter Grace has torn her ACL while skiing at Snowbird, and I’m accompanying her to meet her surgeon, a high-energy, bald man wearing red, white, and blue cowboy boots with the Dallas Stars logo on them. I’m not a Cowboys fan, but I love life’s kooks and while my daughter goes for her X-ray down the hall, he and I cover a wide array of subjects in record time (he seems to be a doctor who is capable of talking and listening), ending with the question of whether he does knee replacement surgeries.
It turns out he does, and in no time, I’m booked for a surgery with him, a full six months earlier than the Sawzall. I felt like Cowboy and I had established some human connection and I was cautiously optimistic. But the system wasn’t done with me yet.