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Re: ACL Reconstruction in NYC - Finding information on doctors...
Message posted January 27, 2002
http://66.54.168.84/cgi-bin/kneebbs.pl/read/160221
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Original posting (response follows)
Posted By: Ryan
Hello,
I tore my ACL and medial meniscus in 1996. I went in for a reconstruction and after waking up after the surgery, was told by my doctor that my knee was stable and that I just had arthoscopic surgery on the meniscus.
Now, almost six years later, I have a completely torn ACL. I should have known after I "twisted" my knee four times that there was a problem. I was hoping that it wasn't torn. I have gotten a referral to a new doctor, however, I would like to research his experience. Can anyone recommmend websites to research docor's histories? Are there any websites that rank/rate doctors? I only want to go through this once.
Thanks for any help.
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Re: ACL Reconstruction in NYC - Finding information on doctors...
Re: ACL Recon - Finding information about doctors...
Dear Ryan,
There are many sites worth looking into. I will start with the most general (i.e. nation-wide) ones, and progress to the more specific (state-based) ones.
American Medical Association Doctor Finder: this site is useful for finding the names of doctors in a given specialty, thus enabling you to develop a list of orthopedists to consult for alternative opinions:
http://www.ama-assn.org/aps/amahg.htm
To check the academic credentials of a doctor, visit the American Board of Medical Specialties website. (This site does require the user to log in, but there are no fees to pay.)
http://www.abms.org/
The website of the Administrators in Medicine (Association of State Medical Board Executive Directors) is also useful, and provides background information on doctors:
http://www.docboard.org/
The Federal Physician Data Center, overseen by the nonprofit Federation of State Medical Boards, comprises a database of over a staggering 117,000 state board actions taken against 35,000 doctors. The database dates back as far as the 1940s. The URL is:
http://www.docinfo.org (Note that conducting a thorough search, via this site, into the possibility of a given doctor harbouring skeletons in his/her closet, requires payment of a user fee of roughly $10.)
But first, here are some other sites (which do not demand user fees) that are worth visiting:
http://www.healthcarechoices.org/profile.htm
http://www.a-r-m.org/check.htm (This one provides mostly Florida-specific links, and thus is not that useful for you, given that you live in New York. But it does give a few other sites worth checking. It also links back to the aforementioned sites.)
Here is a site that is especially useful for inhabitants of New York State. The Medical Society of the State of New York provides several on-line databases specific to this state. Disciplinary and licence-related information is freely available.
http://www.mssny.org/pub_health/Consumer_Physician_Info.htm
Note: If you are consulting multiple doctors for second, third, fourth, and fifth opinions (and for complex knee issues, it is often worthwhile to consult more than just a few doctors), you will want to keep personal copies of all your medical records (including CDs of all MRI scans, printed copies of MRI-imaging reports, copies of all X-rays, copies of doctor's notes and evaluations, copies of surgery reports, and so on). Incidentally, the field of information management and retrieval, as applied specifically to the healthcare realm, is known as health informatics. The field of health informatics has grown tremendously in the past decade, especially given the increasing penetration of computers into every facet of healthcare. I was intrigued to discover that it is even possible to do graduate studies specifically in health informatics. The following site gives a listing of some of the universities that offer degrees in this field. I am including it here merely as a way to illustrate how integral information management has become to modern healthcare.
http://mastersinhealthinformatics.com/
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Keep in mind that a given surgeon who has a record containing some malpractice lawsuits may not necessarily be a bad doctor. It may be the case that this doctor simply takes on difficult (and failure-prone) cases.
It can also be helpful to ask around, regarding knee surgeons. Although anecdotal evidence is not the best form of evidence, sometimes such information can display a trend worth investigating further. For example, if you find that everyone who has had knee reconstruction with Dr. A has had lastingly good results, but that everyone who has gone to Dr. B has experienced extensive post-op complications, then you might wish to do a little more digging.
Of course, not all the relevant information can be gleaned from asking people and searching websites. It is important to discuss your knee problems in detail with the doctor. (It goes without saying that the doctor should be willing to take the time to discuss the knee issues in depth.) I suggest you make a list of all the questions you wish to address, so that you can go through them in an organized fashion.
With regards to ACL reconstruction, ask about the types of grafts and anchorage devices the surgeon prefers. Ask about his/her experiences with the various options. With regards to meniscal surgery, ask whether or not he/she is familiar with meniscal suturing. (In your 1996 surgery, was your damaged meniscus partly removed, fully removed, or repaired? A surgeon who seems bent on removing damaged meniscal tissue is not as good as one who makes every possible effort to salvage every ounce of meniscus.)
The surgeon should have considerable experience with ACL reconstruction and meniscal repair. You want a doctor who focuses on knees, and preferably one who performs dozens of ACL reconstructions each month. It is not necessary to expect the surgeon to have many decades of experience, but a reasonable amount of time practicing as a licensed surgeon is essential in order to have had the opportunity to develop a measurable track record.
You might also wish to ask the surgeon about what he/she sees in the future of knee surgery. Has he/she been keeping up-to-date on the latest developments in fields such as the fine points of reconstructed-ACL biomechanics, meniscal transplantation, and cartilage regeneration? A surgeon who continually does extensive background readings (e.g. in medical journals, such as those accessible via the Knee-Article Library hotlink at the top of each page of this discussion forum) is not as apt to fall behind as one who is content to perform ACL reconstructions in exactly the same fashion as was done when he/she started practicing.
Also ask about rehab protocols, physiotherapy clinics recommended, use of continuous-passive-motion machines, as well as use of bracing post-op and during return to knee-demanding activities. You might also wish to ask about which types of surgical anesthetic the doctor prefers, and which pain-management options he/she considers best.
Another point to look at is the doctor's long-term perspective. A surgeon who does long-term (i.e. minimum of ten years) follow-up on his/her patients is clearly interested in longevity of results...definitely a favourable point. Finally, be sure to ask about post-op complications such as intra-articular infection and scar-tissue formation.
Yours truly, Michael Frind.
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