Why only post doctors who have done more than 100 operations?

[blmjumper]

Pat,

Just curious, why list only doctors who have performed over 100 procedures?

As a parachute trainer, I've had students who are naturals with the skills required and are more than competent at 10 jumps.

I've also had other people I've trained who still don't get it at over well over 100 jumps (and probably never will).

And then there are folks who have done it for so long they don't even think about it....those folks scare me.

IMHO...wouldn't it benefit folks to know of all the doctors who perform the operation with their totals to date and allow the patient to make their own decision?

Seems like 100 is a nice even, but arbitrary number.

The surgeon who is perfoming my operation next week has done less than 100 to date and I have a fairly complicated procedure over the standard resurfacing due to the titanium rod in my femur. We DON'T want to revise to a THR, that would be really, really bad.

The number of operations he's done doesn't concern me.....just his competency as a surgeon.

Back to the fire-fighting world.

Complacency kills...I prefer to work with folks who are knowledgeable, but not done an operation so many times they don't think about it anymore and just go through the movements. There is a fine line between experienced and complacent.

So when has a surgeon done "too many" procedures? I figure, if there's a bottom...there should be a top, right?

Just my .02.

Thanks again for operating this site. It has been very informative and helpful in my education on the procedure.

[Pat Walter]

Hi Blmjumper

I appreciate your comments about exprienced surgeons, but I base my 100 benchmark on a number of things.  One is the medical studies indicating the steep learning curve for hip resurfacing.  You can read 2 of the learning curve medical studies on this page  http://www.surfacehippy.info/medicalstudies.php

The seond is the input from the really experienced surgeons who are the best in the world.  They think my benchmark should be 200 resurfacings.  These are surgeons who have done thousands to many thousands.  Even they will admit that they still have very tough cases which are very difficult surgeries for them.  They have seen it all and done it all - yet realize that they are still learning.  Consistency takes experience in hip resurfacing surgery.

Third is the many number of revisions I have read about from the new less experineced surgeons.  I know of at least 14 loose acetabular cups along with a number of femur neck fractures and other problems.  You don't get the personal emails that I have received over the last 3 years.  The survival rate use to be about 99% for the BHR until the new surgeons started performing resurfacing in the US.  Now it is down to 96%  http://www.surfacehippy.info/bhrhistory.php Of course this means that 96 people out of 100 will not have problems, but if you don't want to be the 4 out of 100 with revisions - then you use the experienced surgeons so there is almost no chance of problems.  You just can't disput the statistics.  The new US surgeons have really lowered the survival rate of the BHR world wide because there is a steep learning curve.

So I stick with my 100 and would really like to change it to 200.  I only list the really experienced surgeons that I would send my brother, sister or freinds to.  I personally would not use one of the newer surgeons.  I paid $18,000 to go to Dr. De Smet of Belgium because the newer surgeons would not consider doing a 61 year old woman.  That is a fact if you read the current articles I wrote after attending the 2nd annual hip resurfacing course in LA in Oct.  I listened to the best in the world including De Smet, Amstutz, Gross, Mont, Schmalzried, Su and many others explain how difficult this surgery is.  How much experienced is required to place an acetabular cup properly.  People use to think femur neck fractures were going to be the problem - but misplaced acetabular cups are the largest problem.  The experienced surgeon is not only a surgeon, but an engineer and an artist.  They can place a cup and cap with more accuracy than the best computer aided surgery.

Also there is no complacency among the top surgeons.  I listen to them discuss their surgeries and how much thought and worry go into each one.  This is a very technical surgery and very difficult - there is no room for complaceny with the surgeons.  I will take Dr. De Smet who has done over 3000 hip resurfacings any day over a surgeon that has done 50.  That is my personal choice.

I know there are many newer surgeons and plenty of people will use them - and generally will have sucessful surgeries, but there is still that chance that they could be the 4 out of 100 with problems.  So I point people to doctors that are out of the steep learning curve.  It is that simple.  It is not a point to argue - it is a point that I base on my 3 years of experience.

I don't want to suggest surgeons that people could become a statistic with.  My goal is to provide good reliable information.  People can go on both the Smith & Nephew website and the Cormet website to find all the surgeons in the US that do hip resurfacing.  You can easily follow the links from the ads on my website.  It is up to each person to decide how much experience they feel comfortable with.

Pat