Over the years, one of the comments we frequently encountered in terms of referrals is “I want the best guy. Money is no object.” It comes as a surprise to many that the best may not be within our country’s borders. For example, the U.S. has some excellent plastic surgeons; however, it can be argued that the world’s finest amongst those were trained in Brazil. Thus, what seems to be a very simple question does not usually get a very simple answer. What people should be really looking for is activity and experience.
For anything elective procedure, I advise the following approach. If you are referred by any of your specialty team to your proceduralist (aka surgeon, specialist), you want to ensure that he is competent and active. Thus the chair of the department of urology who has not performed a surgery in the past 2 years (despite having 20-30 diplomas and accolades his office) may not be the best choice. What you are looking for should by the guy who is in the trenches doing the same exact procedure doing several times a week for some time. A person who is performing this procedure day in and day out has a better insight and understanding that happens with the nuances that may occur during the procedure and is more sensitive to making a fine adjustment for a better outcome. Typically the proceduralist should have a minimum of 5 years doing this type of procedure (10 years is better) and should be still actively doing it today.
One of the examples I like to site is for prostate surgery. There are many surgeons who have done several 100 prostate surgeries. However, if you want the “best” you’ll have to visit Florida to find a surgeon who has done well over 10,000 surgeries and is doing at least 20 a week, Another examples of this in the search for spine surgeons. Artifiicla disc replacements have quickly become the gold standard for this counter. However in places such as Mexico, Germany, and Italy, their experience spans decades. The top surgeons in the us have typically have done 500 artificial disc replacements, where as in Mexico they have don well over 3,000, and in Europe most experience surgeons there have done over 5,000. The more specific the surgery, the more research you have to do. However, as we’ve stated prior, your future is in your hands. The more research you do into finding a specialist, and the specialist himself/herself, you will likely get a more positive results.