Changing Doctors

[Tina_R]

If you want to consult another surgeon, whether it's for a second opinion or just because you feel a change is in order, is it stupid to try to find one in the same hospital or practice? It's not like there are that many hospitals with such specialized surgeons.

Anyone done this?

[LindaRacine]

I think it probably depends on the center, and whether or not you have access to other specialists close by. At UCSF, they usually make it very difficult for patients to see multiple spine surgeons in the same practice. I also think it's less probable that two surgeons in the same facility will disagree with their partners.

[Tina_R]

I think it probably depends on the center, and whether or not you have access to other specialists close by. At UCSF, they usually make it very difficult for patients to see multiple spine surgeons in the same practice. I also think it's less probable that two surgeons in the same facility will disagree with their partners.

I can see where differences between doctors can appear to be criticisms and that that maybe doesn't look so good for those within a practice.

But some doctors specialize in revision surgery, which redoes what another doctor did to some degree. This doesn't necessarily mean that the first surgeon did anything wrong, but they could have. It almost sounds as if revision surgeons and first-time surgeons should be part of separate practices.

I frequent another scoliosis forum and I tell people all the time to get a second opinion. But in practice it may not be so easy to get a qualified second opinion. If there is only one major spine center in your area, you may have to travel for that second opinion. Like poor Nancy/"Scared" who had to go out of state to find even one highly qualified scoliosis surgeon.

[Tina_R]

You get fusion surgery, you see the surgeon every so often for updates. He checks how well you are recovering. That's what I've been doing, of course.

How long and how often do people do this? For me it was every few months in the beginning. Does it go down to once per year or less often after a certain amount of time passes? Surgeons must accumulate a lot of patients and it must be impractical to see all of them too often.

If there are no complications, how often are people seeing their surgeons after months and years pass? Do they ever stop seeing them? Do they ever transition to a doctor who is not the surgeon who did the work but who is familiar with the spine?

[jackieg412]

I stayed at once a year of seeing the surgeon. It could depend on how much they want to follow their healed patients.

[LindaRacine]

You get fusion surgery, you see the surgeon every so often for updates. He checks how well you are recovering. That's what I've been doing, of course.

How long and how often do people do this? For me it was every few months in the beginning. Does it go down to once per year or less often after a certain amount of time passes? Surgeons must accumulate a lot of patients and it must be impractical to see all of them too often.

If there are no complications, how often are people seeing their surgeons after months and years pass? Do they ever stop seeing them? Do they ever transition to a doctor who is not the surgeon who did the work but who is familiar with the spine?

Tina...

It depends on the surgeon, and whether you've enrolled in a study. After a year or two, there's no actual reason to see your surgeon, as long as everything is going OK. If you have significant new symptoms (for more than a week or two), you should definitely make an appointment. If you're enrolled in a study, you've agreed to be seen at different intervals, usually up to 5 or 10 years postop. While it can be a pain in the butt to go in when you're doing well, there's definite benefit to continuing participation in these studies, as that's how they know what works and what doesn't.

--Linda

[Tina_R]

Tina...

It depends on the surgeon, and whether you've enrolled in a study. After a year or two, there's no actual reason to see your surgeon, as long as everything is going OK. If you have significant new symptoms (for more than a week or two), you should definitely make an appointment. If you're enrolled in a study, you've agreed to be seen at different intervals, usually up to 5 or 10 years postop. While it can be a pain in the butt to go in when you're doing well, there's definite benefit to continuing participation in these studies, as that's how they know what works and what doesn't.

--Linda

OK, in the first year, how often do people see their surgeon? Especially how long after the surgery is that first checkup for most patients?

[LindaRacine]

OK, in the first year, how often do people see their surgeon? Especially how long after the surgery is that first checkup for most patients?

At UCSF, the standard of care for deformity surgery follow-up is 6 weeks, 3 months, 6 months, and 1 year.

--Linda

[KathyInIowa]

At UCSF, the standard of care for deformity surgery follow-up is 6 weeks, 3 months, 6 months, and 1 year.

--Linda

I had my surgery at Twin Cities Spine Center and my first year follow up was the same as what Linda said about UCSF.

Kathy

[Tina_R]

There's no need to see your surgeon after a year or two...as long as everything is all right.

Nothing has ever been all right for me, though. I haven't reached the "all right" stage.

[Tina_R]

I think it probably depends on the center, and whether or not you have access to other specialists close by. At UCSF, they usually make it very difficult for patients to see multiple spine surgeons in the same practice. I also think it's less probable that two surgeons in the same facility will disagree with their partners.

Linda, this answer has been bothering me a bit and one thing I don't understand is, how will the second doctor know what the first doctor concluded? Isn't that a breach of patient confidentiality, or is patient information open to all doctors at a given facility?

[LindaRacine]

I don't know about everywhere, but at UCSF, all doctors have access to all patient records, provided there's a medical reason for accessing a record. I suspect a patient could opt to have their records locked, though it seems there might be some danger in doing such a thing. Most institutions also allow patients to opt in to sharing records between institutions.

[Tina_R]

Tina...

It depends on the surgeon, and whether you've enrolled in a study. After a year or two, there's no actual reason to see your surgeon, as long as everything is going OK. If you have significant new symptoms (for more than a week or two), you should definitely make an appointment. If you're enrolled in a study, you've agreed to be seen at different intervals, usually up to 5 or 10 years postop. While it can be a pain in the butt to go in when you're doing well, there's definite benefit to continuing participation in these studies, as that's how they know what works and what doesn't.

--Linda

I doubt I was enrolled in a specific study. I was asked if I would allow my medical information to be added to a database, presumably to be available for statistics. I was all for it and started to fill out a questionnaire for that purpose. I was rushed to do some test or something and never completed the questionnaire on the tablet they gave me, so I think it was lost. Because I didn't complete it, I don't think I was ever added to the database. I mentioned it later but no one seemed to care. Yet another thing that ticks me off about the hospital I went to.

[Tina_R]

I don't know about everywhere, but at UCSF, all doctors have access to all patient records, provided there's a medical reason for accessing a record. I suspect a patient could opt to have their records locked, though it seems there might be some danger in doing such a thing. Most institutions also allow patients to opt in to sharing records between institutions.

With hospitals merging all over the place and everybody part of a very few big families it's hard to get a second opinion that isn't going to be influenced by the first opinion, isn't it?

[LindaRacine]

With hospitals merging all over the place and everybody part of a very few big families it's hard to get a second opinion that isn't going to be influenced by the first opinion, isn't it?

Only if the institution where you were treated acquires another institution where you want to be evaluated.

If you're concerned that your surgeon will share information that might influence other providers, I would recommend that you get a copy of all the clinic notes. Read them over carefully. If anything is incorrect or untrue, you can challenge that information and ask that it be revised.

On the other hand, if there is information in your records that is true, and makes it appear that you were a difficult patient, you might consider writing to your surgeon, explaining about your frustration, being careful to not blame them. While I'm sure it's difficult for surgeons to treat patients that make it seem like they're being blamed or accused of doing something to cause a poor outcome (I'm not saying that's what happened with you), they're typically smart and compassionate individuals, who want you to get better. I'm not saying you did anything wrong, but if you can't get help from anyone, perhaps it's a good idea to switch strategies.

--Linda