In 2000 when I was living in California, I had some surgery done by a really outstanding surgeon in Oakland. The surgery at the time was somewhat unique: total ankle replacement. For the first few years, I had no problem going back to him for followup visits to make sure the thing was still working fine. Then I moved to Virginia. For a few more years, I scheduled followup appointments to check on it every other year because it was then a hassle to fly transcon to see him.
I have on occasion asked him if there was another surgeon on the east coast who he perhaps trained (he had been doing that when he did my surgery) or at least knew by reputation as a good doctor, and he always declined in favor of having me come back to him. I totally understand that he wants to monitor the progress of what is essentially his work. But from my point of view, I can’t always afford or find the time to go back to him. And now that my device is more than 12 years old, it may be wearing out and may need to be replaced soon (While they used to say it had a 10-year lifespan, lately he’s been saying that they actually don’t know how long they last. I guess it depends on the individual.)
My ankle lately has been a little sore off and on, and has been oddly bruised. My regular docs both diagnosed it as simply pupuria or age-related blood pooling in the legs, nothing to worry about. But I would like to have the surgeon check it. In addition to the time and expense of flying out to California for an office visit, I’m wondering what to do if he does decide it needs to come out. File for disability leave with my employer, book a hotel for a full month and then hang around Oakland while we get things sorted out? Really my question for you all here, is how you might go about finding a surgeon more local to pick up the continuing care for this thing.
I reached out to the manufacturer of the device once to ask if they could provide a list of surgeons who use their device (the one I have, because it’s quite different from others that are in use). They declined to get involved and referred me back to my surgeon. So I feel a little stuck. I want to be a good patient, and I really like that surgeon, but since I’ve moved it’s just not practical to keep going back to him. What would you do?
Get a local Primary Care Physician PCP where you are living now. Then ask for a referral to a surgeon in your area FOR THE PROBELM YOU ARE HAVING [not the manufacturer of the device you have].
As years pass, new and different devices will become available. It could be there is something newer and better out there. And based on the experience you have had with the previous doctor and the manufacturer of the device, sounds like a change away from both might be best!
Actually, the device I have is still considered bleeding edge (haha, I pun). It requires the least amount of bone removal compared to it’s competitor devices, so for followup care I do want to stick with a doctor who has been trained in it’s use and care. If it has to be replaced, then we can discuss alternatives, but for now we stick with it.
Hmm, I just googled for the device and my location and NOW I am finding surgeons in this area who work with it. So then, I guess my actual question for doctors is if this would really be a problem from your perspective - that is, having a patient move to another doctor, or having a patient come to you from another doctor. It’s done all the time for other illnesses/treatments/etc. But for a specialty implanted device, is it frowned upon?
It’s a STAR™ total ankle replacement, if you’re curious.
What you are doing is like going to a doctor and telling them which prescription drug you want them to prescribe for you!
I don’t think doctors spend all that time in school to have patients tell them what is the best course of action. Best to get a referral and let the doctor suggest the best course of action. If you don’t like what he/she says, then get a second opinion. If two doctors are saying the same thing, might be a good idea to follow their advice.
A PCP is not going to know which local orthopaedic physicians handle an unusual arthroplasty like this unless he/she happens to have another patient who had the procedure done. I would just call the local foot and ankle practices and ask if they have physicians on staff who do the procedure. Get a few names, then Google for general reviews.
It would be very unusual in my experience for an orthopedist to demand that a patient keep flying cross-country to see him. Unless your previous doctor invented the joint replacement device, maybe.
Yes, it’s not a hugely common procedure. The original surgeon didn’t invent the device, but he was apparently instrumental in it’s success by doing the FDA studies and going around training other surgeons and giving talks. If you go to the manufacturer’s website they have his picture posted! (Just noticed that yesterday.) But since he’s trained lots of other surgeons on this exact device I don’t really see the need to continue to expend money and time for cross country trips. He’s a brilliant surgeon, but kind of iffy in “bedside manner”. He seems to not care about the patient’s perspective on things much.
I’d consider writing a letter to his Medical board. Yeah, it doesn’t rise to the level of malpractice, but IMO he IS being a bit of an inconsiderate and unprofessional dick about the whole thing.