| Finding and Choosing a Doctor |
| When searching for a doctor to treat Kienbock's Disease, it is imperative that you find a hand specialist! Finding the right surgeon may be the single most important thing you can do for yourself as you deal with your Kienbock's Disease. It is usually a good idea to get two, even three opinions, but when you are dealing with KD, you may get as many different opinions as doctors you see. The idea would be to try to build a consensus regarding your treatment. The disease process dictates that we treat Kienbock's Disease in a timely fashion, and people tend to make hasty decisions which, in this case, could affect them the rest of their lives. The most important thing is that you find a doctor who is skilled and knowledeable, and one you can trust. If you have any doubts whatsoever, go see another doctor, even if it means being in pain a while longer. Don't ignore gut feelings, no matter how silly they may seem. This is your instinctual behavior telling you something isn't right. A few extra, carefully spent weeks now, may save you a lifetime of chronic pain later.
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| Ideally, your potential doctor should have experience with Kienbock's Disease. This isn't such a problem in densely populated areas, but in rural areas, it might be hard to even find a hand specialist, let alone one who has had experience with this rare disease. Generally, it's nice to be treated close to home, but this is an instance of going where you need to. Your hands are important in all you do, so your wrists need to function for a lifetime. |  |
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As most people don't initially visit a hand specialist for unexplained wrist pain, the first step for most people would be getting a referral from their family doctor or diagnosing orthopedic physician. You could ask for several names, but always ask your doctor who S\HE would see if it was their wrist with the problem, or one of their children. They are usually more thoughtful when it is put in personal terms. Then ask friends, coworkers, neighbors....all the people you come in contact with. A referral from a trusted person can be invaluable. You may also consider spending an afternoon at the hospital and casually ask the surgical nurses when you see them roam around. Nurses know who the good doctors are and are often anxious to support them. You can also call your local hospital's doctor referral number. Knowing the doctor is, at the very least, affiliated with a good hospital can give you some degree of comfort. Of course the Internet has opened up an unlimited amount of resources to all of us. If you can't get referrals from people you know, join an online support group such as Yahoo Groups Kienbock Disease Support Group and see if you can get information about doctors in your area (in addition to a wealth of other info). It's quite possible that there will be people living close to you who will have strong opinions about doctors in your area. Still another great place to search for hand surgeons in your area is the American Society for Surgery of the Hand. Besides the "Find a Hand Surgeon" link, this site has a lot of good information that is well worth a read. It explains what hand surgery is, what hand doctors should be, conditions of the hand and wrist, and other good, basic information. Next, try the American Medical Association's DoctorFinder. It provides basic information about nearly 700,000 doctors in the United States. It lists both members and non-members of the AMA. According to the AMA, members promise to follow the highest ethical standards.
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The idea is to build a list of names of hand specialists in your immediate geographic vicinity. Then you can investigate the doctors more thoroughly. Information about physicians can be hard to find. You can check your health insurer's Web site. Most insurance sites allow you to search by location, specialty and sometimes gender. |
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Of course, insurance sites will only list physicians who participate in your health plan, but their directories of in-network doctors should be up to date. You may be left with dozens of choices and little more then the doctor's office address and phone number to go on. However, once armed with this information, you can do a search on Google (for example), and visit each individual doctor's web site. Often, reading their educational and training background will be quite helpful. Look for familiar names when reading a potential doctors' educational background. Training at well-known schools such as Harvard, Duke, John Hopkins, UCLA, Mayo Clinic, or Washington University School of Medicine might be considered when judging your doctors' profile. Your potential doctor should also have served a fellowship for his\her added qualification of hand surgery. This should also be accompanied by training in microvascular surgery. Again, look for a hand fellowship at one of the better training facilities, such as the Indiana Hand Center, or the Kleinert Institute. This isn't a guarantee that the doctor will be good, but the more things he has in his favor, the better. As you look over the medical training background, pay attention to the year of graduation. This will give you an idea of the doctor's age and how many years s\he has been practicing. Some people feel that an older doctor will have more experience and will have seen it all, however in some cases, an older doctor may have eroded surgical skills and judgment, or may have stagnated professionally and not be up to date on the latest techniques and procedures, while others have become rusty resting on their laurels. On the other hand, a younger doctor should be current and up to date, but possibly doesn't have the experience or bedside manner you're looking for. This comes down to your own personal feelings, but should be taken into consideration as you are qualifying your prospective candidates. Gender is another thing you should make note of if that is important to you. Gender shouldn't matter as far as skills go, but it can make a big difference in your level of comfort. You may want to give it some consideration when making your decision. Doctors who publish a lot of articles may seem quite impressive, but this sword cuts both ways. It's important not to let yourself become "starstruck." While this certainly might indicate a totally driven, workaholic, intellectually inclined sawbones, proficient in academia as well as the surgical theater, it could also be a doctor who prefers to research and publish and leave the surgery to someone else. He may just lack the necessary experience or surgical skill to treat you. You might be able to get a "feel" for a doctor by looking at their Web site. Is it esthetically pleasing? Informative? Professional? Likewise, the doctors' office and staff usually are a reflection of the doctor as well. When you visit the office, is the staff courteous and helpful? Are they knowledgable? Do they return your calls right away? Is the office bright and cheery? Clean? Modern? New equipment? Informational brochures, or just some old copy of Highlights? You can get more information from state medical boards. State boards offer information on a doctor's license status, education and specialties. You can also find out whether specialists are board certified. Licensure is required; board certification is voluntary. Some states, such as California, Connecticut and New York, require physicians to disclose disciplinary action or outcomes of malpractice suits. Each state has its own medical board. Some are independent, while others belong to a larger group, such as a department of health. However, all belong to the national Federation of State Medical Boards The Federation of State Medical Boards (FSMB) lists individual medical board sites. However, it's difficult to tell where your potential doctor has previously practiced. Doctors with poor, or downright bad, records sometimes move to different states. The FSMB can check the records of every state. For $10, you can get a doctor's full disciplinary history. Each record includes the reporting state and the nature of the incident. The service is called DocInfo. It claims to have recorded 156,000 disciplinary actions related to about 46,000 doctors dating back to the 1960s. It charges $10 per doctor's report. Disciplinary reports are free from some state medical boards. Try searching using the Administrators in Medicine's database, which will search more than a dozen states' medical boards. Not every state is included in the database, but the site provides links to medical boards of states that aren't. It's also a good idea to check out the hospital that the doctor is affiliated with. Hospital affiliations can give you some idea as to the quality of a doctor, so it's worth it to check the quality of the hospital. The best doctors tend to look for the best hospitals, and vice versa. While it has nothing to do with hand surgery specifically, try checking out the Department of Health and Human Services (DHHS) to compare hospitals' quality of care for various medical conditions. The site currently includes data on the quality of care for heart attack, heart failure, pneumonia and post-surgery infection, but this is indicative of their commitment to overall care and quality medical service. The results show each hospital's quality as a percentile. The results represent only hospitals that voluntarily submit data. Healthgrades is another place you can turn if you are interested in really checking out your physician. This site can instantly generate a report, for a fee, about your doctor that includes;
The current cost of the report is $17.95. You can however, freely use the Healthgrades website to generate a list of surgeons in your area, as a means to begin your search.
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Who do you want? | |
What is a hand surgeon? | |
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Look for a doctor who: | |
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What you should know about your doctor:When choosing a treatment, make sure you understand:
What your treatment options are.
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Who to avoid!! | |
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Gut feelings are quite valid and should be listened to. If you feel there is something creepy about a doctor, keep looking.Don't settle!! |
Always be on the lookout for RED FLAGS !! |
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A doctor who says "Nothing can be done to treat Kienbock's Disease"Ok, I picked a doctor, now what? |
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Once you have decided on a doctor, it is important that you remember that you have a responsibility to this relationship as well. That's exactly what this is, a relationship, and one that will at least span several months, and quite possibly years. Like any good relationship, it's important that both sides work at it! There are certain things you should tell your doctor when you visit: It's a good idea to bring someone with you when you visit the doctor, either a spouse, family member, or close friend. There are several reasons for this. One reason is to have someone who will listen well to what the doctor has to say and will advocate on your behalf if necessary. Many people may be anxious when they visit a doctor, and their pain can cause them to be in an emotional state in which they might be apt to commit to the first thing the doctor says. Intense, chronic pain can literally drive people to make decisions they may later regret ("I'd do anything to stop this pain!!").Secondly, a lot of people become quite distracted when there is talk of surgery and it helps to have that second set of ears when recalling the visit. Your companion can also take notes, as you may not be able to. In lieu of that, ask the doctor if he minds you recording the conversation with a micro recorder. This is a good idea anyway if you are having a problem taking notes, as many hand patients do. Lastly, it's nice for the doctor to get to know your companion well ahead of any surgery you may have. You will need to have someone accompany you when you have surgery, and it's nice for the doctor to feel that he or she already knows your friend or spouse when they discuss the surgery or post-operative instructions. It just makes for a much happier relationship all the way around. Another good idea is to call the doctors office and ask them to send you the insurance forms and pain charts before you go to the visit. This is important for two reasons. First, it is far easier to fill these out at home where you have plenty of time to do them rather then trying to work on it quickly in the few minutes you might have before the doctor calls you back. Second, if your hand\wrist is bothering you, you may need to take several breaks. Another part of your responsibility as a patient is to LISTEN to what your doctor says regarding your post-operative instructions. The cast is there for a reason! Nobody likes them, but you don't cut it off! If your doctor tells you to move your fingers, move your fingers! If you are told to elevate your hand, then elevate! If he tells you not to pick up anything heavier then a can of soda, don't! These instructions are there for a reason, and your doctor depends on you to do your part to have a successful outcome. It is important that you listen closely to your doctor and understand what he or she is explaining to you. Learn as much as you can about your condition. Ask your doctor or nurse to explain it to you and make sure you use reliable sources for all information that you seek. The more you can learn about your condition, the better the decisions you will make for yourself, and the better your outcome will be!
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| Comments or questions in any way concerning Kienbock's Disease are best directed to the Yahoo! Kienbock Disease Support Group. |
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