How Important is Bedside Manner? (MRI, xray, pain, ankle)

[Scooby Snacks]

I'm having orthopedic shoulder surgery for repeated dislocations in a month or two. I had this done several years ago, but the problem has recurred, and this new surgery will probably be more extensive and involved than the original. Orthopedic surgery usually involves a long and painful recovery, and this one will be more so than most, because it's a repeat of the first, so the shoulder will be immobilized for several weeks, followed by many weeks of physical therapy.

The problem is the orthopedic surgeon. Anyone who has dealt with these creatures knows that most of them are just plain jerks. But they get away with it because their services are desperately needed. Almost everyone suffers a broken bone, joint, tendon or ligament injury at some point in their lives, so they always have plenty of work. I have been treated poorly by this group practice in several ways. Since I have had several orthopedic surgeries, I have spent a lot of time with orthopods, but this practice is the most impressively bad. It's already taken nearly one month seeing them, and I have yet to get an MRI detailing how extensive the shoulder surgery needs to be, which is incredibly slow. Meanwhile, I'm in pain and wearing a sling at night.

There is the usual excessive wait time due to overbooking. Another issue is long wait times for my testing and office visits because they only schedule this and that once a week, along with getting bounced from one doctor to another, all at significant extra cost to myself. And there is also excessively long wait times to get an appointment because strangely enough, the doctors don't have clinic every day. They all take days off. I have never experienced this in other practices.

My dilemma is the fact that I have a complicated shoulder problem. The doctor who treats them works at this dysfunctional practice. He is probably the best doctor in the city to take care of me. But I dislike how I have been treated. I can go to many other surgeons, but I'm not sure they will do as good a job, because he is a shoulder specialist. Many orthopedic surgeons are generalists who do everything, and this doc only does shoulders. Should I stay because he is the best, (thus rewarding bad service,) or should I move on to a better practice? I will have many appointments with them after the surgery, so that means many more encounters and more frustration. It would probably still be successful if I see someone else. Has anyone else experienced this? Group practices are horrid compared to private practices when I have dealt with them.

[Nov3]

I would not qualify this as bedside manners, as that is usually during the recuperation phase. What you are describing is the Office practice on scheduling and accessing in a timely manner.

I would suggest seeking a practice that meets you at each phase in this healing process. From attentive service, remedies, and testings.

[Scooby Snacks]

Originally Posted by Nov3

I would not qualify this as bedside manners, as that is usually during the recuperation phase. What you are describing is the Office practice on scheduling and accessing in a timely manner.

I would suggest seeking a practice that meets you at each phase in this healing process. From attentive service, remedies, and testings.

I didn't think about it that way. Fortunately Houston has one of the best medical centers in the world, and I have good insurance. I was thinking about obtaining my MRI from this practice after I get it next Monday and just bringing it to another doctor. Once the new one gets the films, they can make a decision about surgery, because that is all they need.

[coschristi]

It sounds like the classic top doc/bad office. How is your experience with the doctor himself?

As both an RN who worked in Surgical/Trauma & as a patient myself; I have noticed this strange phenomena of the better the doctor is, the worse his office seems to be.

I have switched doctors because of the office but if your doctor is great I would hang in there. When you become an inpatient at the hospital the nursing staff becomes your liason with the doctor & you have the benefit of a good doctor without the frustration of being juggled by incompetent office people.

I feel your pain; there is nothing worse than being in pain/worried about a surgery & then having to deal with procedures that don't get scheduled right, prescriptions that don't get called in etc ...

I'd also mention it to the doctor himself. Sometimes they don't have a clue what happens when you leave the exam room.

If the doctor himself is a pain in the *ss I would try someone else UNLESS his success rate makes up for his personality.

I've seen that too. There are a few doctors here that the nurses hate to work with but we admit that if it were OUR loved one who needed help; they would be the 1st choice because they are just THAT good.

[nmnita]

I think specialists over all can be jerks and what you are describing is, as mentioned more a staffing problem. To me bedside manner is very important, and if you can, find a doctor and office you are more comfortable with. As you said, the recovery can be very long. you want to be satisfied with both the outcome and the people you will be working with. Yes, Houston has many choices. Now, if it comes down to being satisfied with the doctor and the office or having a complete recovery, go with the doctor.

We are lucky here in NWA we have a couple of large Orthopedic clinics with very good and very nice doctors thank goodness. The one that did my knee a few years ago was outstanding with a very pleasant personality even though he ran on a very tight schedule. I have also changed doctors on more than one occasion when either I didn't care for him or her or I didn't like the overall feeling in the office.

[Scooby Snacks]

Originally Posted by coschristi

It sounds like the classic top doc/bad office. How is your experience with the doctor himself?

As both an RN who worked in Surgical/Trauma & as a patient myself; I have noticed this strange phenomena of the better the doctor is, the worse his office seems to be.

I have switched doctors because of the office but if your doctor is great I would hang in there. When you become an inpatient at the hospital the nursing staff becomes your liason with the doctor & you have the benefit of a good doctor without the frustration of being juggled by incompetent office people.

I feel your pain; there is nothing worse than being in pain/worried about a surgery & then having to deal with procedures that don't get scheduled right, prescriptions that don't get called in etc ...

I'd also mention it to the doctor himself. Sometimes they don't have a clue what happens when you leave the exam room.

If the doctor himself is a pain in the *ss I would try someone else UNLESS his success rate makes up for his personality.

I've seen that too. There are a few doctors here that the nurses hate to work with but we admit that if it were OUR loved one who needed help; they would be the 1st choice because they are just THAT good.

I have only met this surgeon once. My initial visit was bizarre. I met with another orthopedic surgeon who diagnosed my problem (correctly) just by palpation, theorized my need for surgery, and prescribed a CT scan to confirm the diagnosis.

Fast forward two weeks: I returned for a follow up with the same surgeon. He came in, told me the CT scan confirmed the problem and that I would need surgery, that he was NOT the surgeon to do it, and that he was referring me to another surgeon in the practice, who would probably prescribe an MRI! I was incensed. If he knew what the problem was, knew he couldn't take care of it, and knew the other surgeon wouldn't accept a CT and I would need an MRI instead, why on earth did I bother seeing him again and wasting two weeks of time scheduling and paying $109 on a useless CT scan? And every office visit costs me $50.

Several days later, I saw the correct surgeon (another $50 down the toilet), who said I needed a $300 MRI scan and that he would order it "stat." Stat at this practice means in two weeks. When I tried to schedule the follow up visit to discuss the MRI results after the scan on the 26th (for another $50), they told me the doctor was not in on any Thursday or Friday, he was the only person who could talk to me about them, which means we're rolling over to the following week again (and he only sees patients in the afternoon). At this point, I was over it and am thinking of making an appointment to see someone else.

I have also worked in medical (ophthalmology) in a variety of roles, including surgery, and have only worked in one group practice. Group practices emphasize the profit factor more because they have more overhead, I believe, and the level of confusion and ball dropping that occurs when there are several doctors at the same place is multiplied exponentially. The private practices offer more individualized attention by all staff members and mistakes occur less often.

[jaminhealth]

Oh boy, at my initial visit to hip surgeon, my friend and I looked at each other with disgust. His manner was horrid BUT he came highly recommended. So I went with him, and his job on me turned out to be a MESS. Probably in a hurry on Friday afternoon. I'm pretty sure this surgeon's manner is due to his cultural roots. We get all these insights after the fact.

That being said, it's a crap shoot, all these surgeries and you just have to go with your gut.

Prolotherapy can help with surgery already done and gone wrong and those trying to avoid surgery. What it does is tighten the ligaments and tendons around the joints to stabilize the problem joints. I'm doing Prolo on my knee now with a D.O. to stay away from a knife.

Good luck.

Oh, I put an online review on my surgeon and he got many reviews, and many on his manner.
.

[Texas Ag 93]

As you are aware, Shoulder is extremely complicated and very specialized. You don't want a General Orthopedic surgeon doing it if you can avoid it (and you can). There are dozens of shoulder and elbow specialists in Houston. The two biggest (and arguably, best) Ortho groups in Houston are those affiliated with Methodist or Fondren Orthopedic Group. Maybe Texas Orthopedic Hospital as well. If your provider is not at one of those, check them out. If he is at one, go see someone at the other.

Most Ortho practices are sub specialists now. It is not at all unusual to see one surgeon first, who then refers you to another surgeon. My husband does Ortho Foot and Ankle in Houston. If he was on call, and someone came into the ER with a really complicated shoulder (or Hand, or whatever) issue, he will refer it to one of his partners. Sometimes that means multiple visits, but the goal is to get the patient the best possible care with the most qualified surgeons.

As far as the timeframe you are dealing with, I'm not sure you'll see much improvement by changing providers. The surgery you need is considered elective and appointment times for scheduling cases, or even imaging, is usually in the "weeks" range, not days, not to mention that since most providers work in large groups and share space and staff, they only do clinic or cases on certain days and times. I do agree with coschristi's suggestion about bringing it to the doctor's attention in the event that there are some office management issues.

[Mikala43]

My husband just had surgery earlier this year by a doctor with HORRIBLE bedside manner, I almost got in an argument with him for his rudeness.

Surgery didn't take.

We went somewhere else, where the doctor did xrays, looked at it and said his was too complicated and took him across to a specialist. That doctor ordered an MRI to ensure that there was no damage that they had missed before he starts cutting him up.

Hubby is currently healing from the 2nd surgery and we are crossing our fingers that there are no problems.

Similar to your story.

[JanND]

Sounds like you need to change Dr's and/or facilities.