Choosing Your Total Joint Replacement Surgeon

Today’s blog will focus on the practical aspect of choosing a joint replacement surgeon. From

my experiences as the fellow at the Texas Hip and Knee Center as well as those with numerous

other joint replacement surgeons, I have seen many different approaches to patient care just

within the subspecialty of joint replacements. Each surgeon approaches their role with slightly

different past experiences, influences, goals, and skills. In this guide, we will review some

aspects of this choice that I feel are important for your decision.

Personality

In my opinion, one of the most important aspects of your search involves finding a surgeon with

a personality that suits yours, as the personalities amongst Orthopedic surgeons varies

substantially. I feel that this is incredibly important because the relationship with your joint

replacement surgeon is likely to be a long-term interaction. Many of our patients return to

clinic for years after their joint replacement to undergo routine surveillance x-rays and

evaluations, so building a solid relationship is essential.

When it comes to the types of personalities you will find, anything from authoritative to laid-

back, high-strung to even-keeled, and dressed-to-impress to wearing scrubs at all times can be

easily found. Interactions in clinic can be quite different depending on the surgeon as well, with

some surgeons directing the majority of the conversation while others will allow the patients to

speak for the majority of time. Speaking of time with you as the patient, this will vary quite a

bit depending on the surgeon you choose. Some clinics will see upwards of 60-70 patients in a

clinic day, which may only afford each patient 5-6 minutes with the surgeon. Other clinics may

be structured to limit the number of patients and allow 15-20 minutes per patient. As the

patient, if you are the type of person who likes to ask questions and ensure that every question

is answered, the latter may be a better choice for you. However, you should know that a

surgeon willing to allow you to ask all of your questions will likely do the same with all patients,

so those clinics may routinely run behind schedule. Other patients may simply feel that their

surgeon knows what questions need to be asked and, once that is complete, would prefer to be

seen on time and get out of the clinic quickly.

Reputation and Recommendations

Just as important as the surgeon’s personality, other aspects I find distinctly important

are the reputation the surgeon has built in the community and recommendations from

other patients. Beginning with reputation, many surgeons spend years, if not decades,

caring for patients in much the same way. While aspects of that care will certainly

change, a surgeon’s unique approach to medicine will be similar throughout their

career. As the patient, you can begin to evaluate a surgeon’s reputation through on-line

review sites and by asking friends, family, and acquaintances. Approach the on-line

review sites carefully, though, just like you would when reading on-line reviews of

anything else. Patients who are overly satisfied and those whose care may not have

gone as smoothly as the patient or surgeon would have wanted are the most likely to

leave reviews on-line. Instead, look for trends in the reviews you read and see if you

can get a sense of the surgeon you are evaluating. Along the same lines, personal

recommendations from people you know and trust can be very informative. Given that

we tend to associate with other people of similar mindset and personality, a surgeon

that a friend or family member was satisfied with is more likely to match your search

criteria as well.

Team and Facilities

As the patient, you will interact with many more people in the Orthopedic practice than just the

surgeon. The entire surgical team, therefore, is very important. For example, most surgeons

employ physician assistants, nurses, and medical assistants to help with the care of their

patients. Especially since surgeons spend a great deal of their time in the operating room,

patient questions, phone calls, and some face-to-face interactions will be carried out by the

other members of the surgeon’s team. I would recommend paying attention to all members of

that team when you are seen in the clinic, since it will give you an idea of how well the unit is

working together. Remember that you will rely on all of those team members for information,

answering questions, and providing care beyond what the surgeon provides directly.

Along those same lines, evaluate the facilities where you are seen in clinic and where surgeries

are performed. You want to ensure that you are comfortable wherever you are cared for and

that the system provides excellent care for their patients. Inquire about the ability of family

members to visit and possibly stay with you in the hospital, if that is of particular interest to you

or would make you more comfortable. Lastly, ask family and friends about their experiences in

different facilities to learn even more. As a surgeon who has worked in large inner city

academic centers, military and other federal hospitals, and smaller subspecialty hospitals, I can

safely say that the patient experience can be very different depending on the location where a

procedure is performed. That’s not to say that one of these types of facilities is better than

another, simply that you should research the options available to you and make the best choice

for your unique situation.

Technology and Surgical Approach

Patients present to the Orthopedic office with distinct differences in their level of knowledge

and expertise regarding medicine and their condition. Some patients have reviewed as much

information as possible regarding total joint replacement before the first clinic visit, while

others may have difficulty understanding the information or have little to no experience seeing

others go through this type of surgery. For those patients who enjoy researching surgical

options and techniques, another important aspect of choosing a surgeon may be the types of

implants, technology, or surgical approach that the surgeon uses. To learn more about these

topics, refer to earlier blog posts where we covered each of these in detail. If you are a patient

desiring a direct anterior hip replacement, for example, look for these details in reviews or the

surgeon’s bio page on their medical group’s website. You could also call the clinic where the

surgeon works and ask whether the surgeon performs the type of surgery you would prefer.

Another example would be the use of robotic assistance, if that is important to you, since some

surgeons do not use those techniques in their practices.

Conclusions

As a patient in need of a joint replacement, you hope for the most caring, accommodating, and

seamless process as possible. It is my strong belief that this starts with the surgeon whose

personality matches what the patient desires and whose entire team is strong and cohesive.

Only then will you have all of the components needed to make this happen consistently.

However, this must be supported by facilities prepared to provide whatever needs the patient

may have, from pre-operative, intra-operative, and post-operative care. The facility also must

have the surgical expertise and equipment needed by the surgeon for completing the

procedures and a reputation built upon a history of performing these procedures with low

complication rates for a long period of time. At the Texas Hip and Knee Center, I can assure you

that all of these qualities and components are met for each surgeon’s team and in each facility.

I hope that this guide will provide some direction in your search for the right team.