Choosing A Surgeon

Questions to ask your surgeon…

Patients should know their treatment options including non-operative treatments. This should be explained in detail by their surgeon. They should also know the potential consequences of not undergoing surgery. A second opinion is never a bad idea especially if their surgeon is recommending a fusion. No surgeon should be offended by a patient receiving a second opinion. Spine treatment recommendations can vary significantly between providers. Some surgeons are much more aggressive and tend to recommend fusion when less invasive options would suffice.

  • What is a realistic outcome?

    This is one of the most common reasons for poor satisfaction following spine surgery. A patient and surgeon should be on the same page with respect to the goals of surgery. For example, surgery for a pinched spinal nerve is often performed to treat symptoms down the arm or leg (pain, numbness, and/or weakness). If a patient’s main reason for having surgery is to treat neck or back pain, they may not be happy with the results. The surgeon will think surgery was a success if the patient’s arm or leg symptoms resolved, but the patient will not be satisfied since they will likely still have chronic neck or back pain. These types of situations can be avoided with proper communication between a surgeon and patient prior to surgery.

     

    (Dr. Stone spends considerable time with his patients prior to surgery to make sure they understand the procedure and have reasonable expectations.)

  • What are the risks of surgery?

    No surgery is without risk. However, the risks of most spine surgery are low in the hands of an experienced spine surgeon. Risks will vary based on the type of procedure being performed. Some spine surgeons who perform traditional open spine surgery will claim minimally invasive spine surgery carries more risk.  This is not true in the hands of surgeons with significant experience. Minimally invasive spine techniques are muscle sparing so the infection rates are significantly lower than more traditional open approaches.  In addition, the use of a microscope significantly improves visualization so the risk of nerve damage is less.

     

    (Dr. Stone’s outcomes have less than a 1% incidence of infection or nerve damage.)

  • How often does your surgeon perform your recommended surgery?

    Spine is a very specialized field. In the past, many general orthopedic surgeons and neurosurgeons performed spine surgery with no fellowship training (advanced training following orthopedic or neurosurgery residency). Most hospitals now require spine surgeons to have advanced training in spine surgery in order to have hospital privileges. In addition, it is difficult for surgeons to stay current on newer techniques if they are performing spine surgery infrequently. For these reasons, most spine surgeons today specialize specifically in spine.

     

    (Dr. Stone has performed thousands of spine surgeries and is fellowship trained in spine surgery. 100% of his elective cases involve surgery on the spine.)

  • Does your spine surgeon have hospital privileges? If so, what hospitals?

    Your spine surgeon should have privileges at a local hospital. Although rare, there is a small risk a patient could be admitted to a hospital following surgery in an outpatient facility for medical and/or surgical concerns. If a surgeon is unable to admit a patient to a hospital another provider will often have to do so. In addition, hospitals have credentialing committees that thoroughly vet physicians asking for hospital privileges. It could be a red flag if your surgeon has not been able to obtain privileges at a local hospital.

     

    (Dr. Stone has hospital privileges at EvergreenHealth, Overlake Medical Center, and Swedish Hospital (Providence).)

  • Are there any enforcement actions against your surgeon?

    If you feel uncomfortable asking this question directly to your surgeon, you can check the Federation of State Medical Boards (FSMB) website.

     

    (Dr. Stone has never had any enforcement actions against him.)

  • Will your surgeon actually be performing your surgery?

    Most patients assume their surgeon will perform their surgery. However, surgeons in training often perform many of the procedures in teaching hospitals. This is good to know prior to surgery. This practice is safe as long as the “surgeons in training” are adequately supervised. Some spine surgeons will run multiple operating rooms at the same time. The safety of this practice has recently been questioned since a surgeon can’t be in two rooms at once. Surgical times can be delayed if one room is waiting for the surgeon to be available during a “key” part of the case.

     

    (Dr. Stone performs your whole surgery. He does not use “surgeons in training” such as residents or fellows. Garrett Gray, PA-C assists Dr. Stone during surgery in order to help retract and protect nerves. He also uses irrigation and suction to maintain adequate visualization throughout the procedure.)

  • Who will see you after surgery?

    Some surgeons operate on their patients and then fail to round on them in the hospital or see them in clinic for follow-up. Your post-operative care is very important to your overall recovery. Physician extenders such as physician assistants (PA) and nurse practitioners (NP) are an essential part of most surgical teams. However, they should communicate closely with their supervising surgeon. Despite the use of physician extenders, most patients prefer to see their surgeon at least once after surgery.

     

    (Dr. Stone and Garrett Gray, PA-C work as a team and are both actively engaged in caring for their patients after surgery. A patient’s first post-operative visit is scheduled with Dr. Stone so he can gauge their progress and answer any questions they may have. Subsequent visits are scheduled with either Dr. Stone or Garrett Gray, PA-C.)