Finding a good orthopedic surgeon — or any good physician — is significantly more challenging than finding a good mechanic or the best restaurant in town. Online review sites have proliferated in the last five years, but from a physician’s perspective they leave a lot to be desired.
Sites like Healthgrades can highlight great physicians, but they shouldn’t be your only source. Many physicians I trust and refer family to have terrible online reputations — most don’t dedicate time to monitoring them. A few sour apples (inevitable in any service-oriented field) dominate the available reviews and skew perception. For most good physicians, the bulk of referrals still come through word of mouth.
So how do you actually vet a surgeon? The nine tactics below have served patients and colleagues well.
Verify the provider's credentials.
Sub-specialty training matters. Primary-care sports medicine ≠ orthopedic sports medicine.
First and foremost, make sure your orthopedic surgeon has the appropriate credentials. Not all orthopedic surgeons are equal — some have additional specialized fellowship training in a particular discipline such as hand surgery, sports medicine, or spine surgery.
Be aware that some sub-specializations have similar names but reflect very different training. Primary-care sports medicine training (typically a one-year fellowship after family medicine or internal medicine) is not the same as orthopedic sports medicine training (a one-year fellowship after a five-year orthopedic surgical residency). Depending on what you need, certain training may be more relevant than others.
If you’re comparing doctors, compare the institutions where they trained. A high-volume teaching hospital gave the physician an opportunity to learn their craft effectively. The American Academy of Orthopaedic Surgeons maintains a searchable database of members.
Vet their technical skill.
Call the office and ask how many of this specific surgery the surgeon does per month.
Don’t be afraid to check how much experience your surgeon has with a given procedure. Call the office and ask how many of the specific surgery they perform. You may not get an exact answer on the phone, but asking how many a month gives you an objective way of comparing one surgeon’s experience to another’s.
Two public databases can help you triangulate:
- Medicare Care Compare — the official government tool for looking up physicians, hospitals, and surgery centers. Includes board certifications, hospital affiliations, and patient experience data.
- Medicare Unmasked — Wall Street Journal’s interactive view of Medicare claims data. Useful for procedure-volume comparisons.
Use both with a grain of salt — many physicians limit their Medicare exposure, so the data won’t tell the full story. But if your target doctor sees more than the 50th percentile of Medicare volume for their region, you can bet they’re getting word-of-mouth referrals among that peer group.
Determine their years of experience.
The orthopedic prime is roughly age 40 – 50 — enough reps to hone skill, still eager to adopt new technology.
The prime for an orthopedic surgeon is generally ages 40 – 50. By 40 the surgeon has had enough repetitions to hone their skills. At this age they’re still eager to embrace new technologies and introduce them into practice.
After 50, not always, but for some surgeons human nature takes hold — the tendency is to fall into a routine and become more complacent as new techniques emerge. This is a gross generalization and obviously doesn’t describe everyone, but avoiding the most senile of surgeons is probably a wise idea.
Beware of snake-oil salesmen.
Be wary of a "dazzling" website focused entirely on one new, expensive, non-insurance-approved therapy.
In training I was taught: never be the first, but also never be the last, to adopt new technology. If the physician you’re considering is more eager to sell an all-new cure-all that hasn’t been vetted by professional colleagues and organizations — in lieu of more established successful therapies — be very wary.
For new technologies, we often don’t completely understand their positive and negative effects. Studies and comparisons establish what is truly the standard of care. I personally prefer to let the early adopters work out the problems. Once a technology has passed first muster of the orthopedic community, only then do I integrate it. The exception is salvage situations where you’ve exhausted all reasonable alternatives — then it may make sense to try a more experimental approach.
Typically these snake-oil physicians can be identified by their website alone. If you find a dazzling site entirely focused on some new esoteric therapy, I would not see them no matter how great their reviews are. A good example is the hyperbole around stem-cell injections: research is promising, but no one has demonstrated that stem cells can be directed to grow new cartilage where needed, undo arthritis, restore ligaments, etc. It’s a bit like trying to build a house (the desired tissue) with a pile of wood chips (stem cells) instead of logs.
Use the most under-utilized resource — physical therapists in your community.
PTs see patients before and after surgery. They know which surgeons get good outcomes.
When I was looking for jobs, the strategy I used to identify reliable physicians in a community was calling up the local therapists and asking, “Who does the best ACL reconstruction in the area?” or “Who would you trust with your knee surgery?” Often after only three or four phone calls I had a pretty good idea of who the trusted surgeons were — the names that kept coming up.
Physical therapists are great judges of orthopedic surgeon outcomes because they see patients before and after surgery. They watch the recovery curve from inside the room.
Reach out to local athletic trainers.
ATCs see high volumes of sports injuries and know which surgeons get athletes back on the field.
This strategy piggybacks on the one above. Athletic trainers at your school, club, or community gym see a high frequency of sports injuries. Experienced trainers deal with orthopedic surgeons every day while managing their athletes — they know first-hand which doctors are getting their athletes back on the field.
Ask nurses.
OR nurses have seen the surgeon under stress. That’s inside information.
Nurses are interacting with physicians constantly. They witness patient-physician interactions, and operating-room nurses in particular have seen how a surgeon reacts when things don’t go as planned. That inside information is valuable.
Solicit a friendly nurse’s opinion and they’ll readily share who they think the better physicians are. Even if your nurse friend doesn’t work directly with an orthopedic surgeon, there’s a good chance they know an orthopedic nurse — or someone who does.
Check with your friends.
Orthopedic injuries are common. Your network knows more than you think.
Orthopedic injuries are very common. Check with your network — many people in your circle have had a knee, shoulder, or back surgery, and most can offer good recommendations from lived experience.
Search the doctor online.
Use reviews as one data point, not the only one. Discount any sample of fewer than five reviews.
Just Googling the doctor’s name can reveal a wealth of information. It will pull up the reviews available online for them.
Use review sites as one element of your screening process. Someone with 10+ negative reviews raises red flags. I don’t put much stock in reviews when there are fewer than five — that’s just not a fair sample. Someone with several consistent great reviews is hard to ignore.
The right surgeon for you isn’t just the surgeon with the best reviews — it’s the surgeon whose training, volume, judgment, and bedside manner match what you need for your case. Use the tactics above in combination and you’ll usually converge on the same handful of names.