“You must have surgery … “
20 something years ago I was faced with a very important decision. What specialty would I choose to pursue as a physician? There were many specialties that attracted me … but in the end, I chose Orthopedic Surgery. And why not? As a child I knew my Orthopedist better then my pediatrician … he was a happy gent and really seemed to enjoy what he was doing. I liked sports, I like anatomy … it felt like a natural fit.
20 years later I do not regret my career path.
One of the many benefits (for me) of being an Orthopedic Surgeon is that I rarely have to drop really bad news on someone. There are very very few Orthopedic emergencies and most injuries, if we wait long enough, get better.
Working in a tertiary referral center has been particularly rewarding. No two trauma patients are exactly alike. The clinical thinking necessary to plan someone’s recovery is always interesting.
As a tertiary surgeon I am also asked to see many second opinions — a role I enjoy and take very seriously.
Over the years, as reimbursement levels have diminished, I have noticed a distinct correlation with the number of second opinions I wholeheartedly disagree with.
Some patients unfortunately think that because something is torn it must be fixed. Some physicians feed into that premise by stating that surgery is necessary without even examining someone. Heck, you can email your spine MRI to someone and they will tell you if you are a surgical candidate — Really ???
Our literature is quite clear … a multitude of injuries can safely be treated without surgery … and with a very high confidence level that the you will be able to return to your desired level of activity.
Folks, the world of high tech-low touch medicine is upon us. If you tell someone that X hurts and they immediately choose to MRI the area and then recommend surgery because of a finding on the MRI — all the while without examining you, speaking to you about your goals, and educating you about your alternatives — I strongly recommend getting up and getting another opinion. There are still a number of great docs out there.
Lots has changed in 20 years …
As a NICU nurse, over the years I have worked with hundreds of physicians from just as many disciplines.
Rarely, however, have I encountered such a thoughtful, self-aware doc. Your nursing team, as well as your
patients are very fortunate.
Howard J. Luks, MD says
:-) Thank you!
I agree with you Dawn, his patients are very fortunate. I had to make a decision re knee surgery and after reading Dr Luks honest clinical point of view about surgery, I weighed up the options, and decided against the surgery. Should my condition deteriorate….I may think about the surgery then. I thank you Howard, for helping me to make an informed decision. Wish all surgeons were as people focussed as you.
I had shoulder pain and my PCP’s physical exam immediately showed a problem. He had x-rays and MRI’s taken.
Went to a ortho and he never even looked at my shoulder, just the x-ray & MRI. Told him that my activities included water skiing. His comment was “why would you want to do that”.
Then he said I could not have surgery or have surgery and be as good as new after 3 weeks.
I got out of there FAST!