Second Opinions

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Second Opinion

A lot of my patients recently are relating stories of having surgery that I regard as unnecessary. More charitably, these are surgical procedures whose chance for producing symptom relief is iffy at best.

Most of my fellow internists do believe that too much surgery is being performed, and that the symptoms people are hoping surgery will cure can often be handled by lifestyle changes instead.

Just this year, I have seen:

  • Several women with fibromyalgia undergo unnecessary and ineffective back surgery or joint arthroscopies (in which a scope is inserted into the joint).
  • Patients with irritable bowel syndrome have their gallbladders or their female organs removed. One woman had both removed, and her symptoms were unchanged.
  • No shortage of patients undergoing sinus surgery without first being tested for food sensitivities or treated for yeast (candida) overgrowth.
  • And one “tired” patient having surgery for sleep apnea–without any evidence of sleep apnea during sleep studies.

Now you might be thinking “These doctors are unethical,” but really, this isn’t the case. The problem is that doctors are trained to “fix” things and have a limited toolbox. They’ve got their ever-present prescription pad (use of pharmaceuticals has reached the level of mind boggling). And then there’s the operating room.

So here’s a piece of advice from somebody’s who’s been in the doctoring business a long time. If you’re not in an emergency situation and you’ve been advised to have surgery, get a second opinion. Obviously, don’t try this if your appendix has ruptured, your wrist is broken, or you’ve been in labor for days. But if you yourself are feeling worried and deep inside you’re questioning the wisdom of surgery, trust your intuition and get a second opinion.
I’ll anticipate your next questions:

  • You won’t hurt the feelings of your surgeon if you get a second opinion. They’re quite used to it.
  • If a surgeon acts angry about your independence, consider finding someone else altogether.
  • The doctor you use for your second opinion won’t be miffed if you return to your first surgeon. He or she will be paid (either by you or by your health insurance company) and generally doctors enjoy being consulted for their expertise.
  • Last, and certainly not least, health insurance companies almost always pay for a second opinion. They like the idea they might not have to pay for your operation.

Be well,
David Edelberg, MD

0 thoughts on “Second Opinions

    Well, I can actually speak from experience on this, having had hip surgery myself a few years ago.
    I put mine off for years and tried everything alternative until finally, needing Vicodin to get me through the night, I said, “Enough is enough!” and set about finding a surgeon.
    Because I was (reasonably) young (60) and reasonably active, I decided to explore hip resurfacing rather than replacement. If these two parameters apply to you, then I urge you to look into resurfacing (just Google hip resurfacing and learn all about it).
    Local orthopedists, because they were unfamiliar with the procedure tried to talk me out of it. Ultimately, I traveled to Baltimore from Chicago and underwent the procedure by a surgeon who had done 450 of them. I am so pleased with the results that I have to think twice before I can remember which hip was operated on.
    So, here’s your criteria. (1) Decide on the procedure best for you; (2) if you go for resurfacing, don’t be convinced otherwise by your local doc simply because he doesn’t know much about it; (3) If you go with conventional hip replacement, it’s worth going to a larger medical center and seeing a doctor who literally does nothing but hips; (4) it’s best not to go with someone fresh out of training; (5) it’s not at all unreasonable to ask how many hip procedures your potential surgeon has performed. The number should be in excess of 250.
    Here’s what not to expect. Orthopedists are basically skilled mechanics and (in)famous for lack of bedside manner. I doubt if the surgeon who did my case exchanged ten words with me and never bothered to see me after the surgery. That didn’t faze me at all. I wanted someone who knew what he was doing, not a drinking buddy. Anyway, it’s the nurses who take care of you post-op, not the doctors. Lastly, don’t be reluctant to travel. You can get your post op physical therapy locally.
    By the way, the surgeon who did my hip was Michael Mont, easily locatible using Google
    Hope this helps
    Dr E

    Dr. E
    Posted February 14, 2010 at 3:04 pm

    I am wondering about what I should know before I select a surgeon to perform hip replacement surgery. I have been putting it off for some time, but it is now becoming unbearable. After acupunture, deep massage, steroid injections and pain medications too numerous to list, I have finally accepted the fact that the hip needs to be replaced. I have seen two ortho surgeons, but neither of them engendered the confidence that I need to agree to this major surgery. How do I select a surgeon?

    Noreen Sullivan
    Posted February 9, 2010 at 9:45 am

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