Good doctors in Utah? How to best choose a surgeon/hospital?

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Nesphito

Member
Joined
Jan 29, 2024
Messages
19
Location
Utah
I found out earlier this week that I’m gonna need a BAV replacement. I’m 33 and the rest of my heart looks healthy. I’m thinking about choosing a mechanical valve.

With that being said I have no idea on how to choose a surgeon. Does it really matter? Should I just see the one my cardiologist refers me to?
 
Hi

I seem to recall that there was a website which rates hospitals in the USA. However what I did in Australia (when searching for an orthopaedic surgeon) was contact my insurance company and ask if they had a list of surgeons which were "preferred" by them.

I found a few, called and made some appointments and soon decided who I liked the most. It was all a good experience.

Some related posts
https://www.valvereplacement.org/threads/is-it-rude.888339/post-912755
https://www.valvereplacement.org/threads/when-should-i-plan-for-surgery.861892/post-862205
I just used the search dialog up in the top left to find these
1706743946151.png


HTH
 
Hi

I seem to recall that there was a website which rates hospitals in the USA. However what I did in Australia (when searching for an orthopaedic surgeon) was contact my insurance company and ask if they had a list of surgeons which were "preferred" by them.

I found a few, called and made some appointments and soon decided who I liked the most. It was all a good experience.

Some related posts
https://www.valvereplacement.org/threads/is-it-rude.888339/post-912755
https://www.valvereplacement.org/threads/when-should-i-plan-for-surgery.861892/post-862205
I just used the search dialog up in the top left to find these
View attachment 889859

HTH
I found the hospital ranking site. One of our hospitals is top ranked in the entire country, but poorly ranked for valve replacement surgery. Everything else here is related average or below average. Makes me wonder if I should leave the state.

I’ll take your advice and call my insurance though.
 
Welcome to the forum.

Does it really matter? Should I just see the one my cardiologist refers me to?
You should definitely consult with the one your cardiologist recommends, but I would suggest getting at least one other consult.

The list linked by MdaPA is a good starting point. There is also a website which has the stats for each surgeon, in terms of success rate and volume. I used it to narrow my list down, although I don't remember the name of it.

I would say that ideally you want to look for the following:

-high volume nationally ranked hospital. You want them to do hundreds of valve surgeries per year, not dozens.
-High volume experienced surgeon with an above average patient survival rate
-Have consults with 2 or more of the surgeons on your short list. Ask a lot of questions. Keep in mind that some of the best surgeons are not good at social skills and sometimes are somewhat arrogant. I would try to ignore that and focus on their experience and reputation.
-There are probably a few members who have had valve surgery in Utah and hopefully some will chime in with recommendations.

Good luck in the road ahead and please keep us posted in your journey.
 
I’d like to second or third all of the recommendations about talking to more than one SURGEON. For the record, I only talked to my cardiologist and his recommended surgeon. That could have been disastrous. My cardiologist recommended a tissue valve for me. Why? I won’t even regurgitate it here because it made no sense (in retrospect). A lot of the younger doctors are, unfortunately, being steered toward non-mechanical options here in the USA. I can only guess that the medical device community (Big Pharma) is behind that push. Couple THAT with the INCORRECT thought of “you’re young, you don’t want to be limited by blood thinners” and you have a large group of cardiologists in this country that don’t truly understand the ramifications of recommending tissue valves as much as they do.

So - get second and third opinions AND be your own advocate. The latest video from the Mayo Clinic posted on this board somewhere shows the Mech valves lead to better outcomes for quite some time.

One of the best questions that I asked my surgeon was If HE was forced to replace his aortic valve at MY agen then what would he choose and why. My surgeon said mechanical (and he does both valves). The obvious reason is that you’re setting yourself up to not have another surgery. The tissue valve could go in 5-8 for someone who is young and active.
 
Hey Nesphito,
Appreciate your post as we just bought a home in Ogden and are planning to retire there in a few years full time (currently living in NM).
The posts above are great. Two recommendations from me:
- surgery is a big deal. Put in the time and research. Find the best valve type/procedure/surgeon/hospital for you.
- If the answer is not in UT, travel out of state. I flew from Albuquerque to Cleveland to get to what I thought was the best for me (Cleveland Clinic, Dr. Svensson). I was not disappointed and am doing great today (2-1/2 yrs later).
Wishing you the best!
 
Mayo Clinic in MN is also very well organized to work with patients from out of state. When I talked with them about planning for surgery, they used the test results from my other hospitals for advance planning. Then the day before my surgery, they did the various tests that they thought needed to be updated. So i actually only had to travel to Mayo 2 days before my surgery.
 
Hey Nesphito,
Appreciate your post as we just bought a home in Ogden and are planning to retire there in a few years full time (currently living in NM).
The posts above are great. Two recommendations from me:
- surgery is a big deal. Put in the time and research. Find the best valve type/procedure/surgeon/hospital for you.
- If the answer is not in UT, travel out of state. I flew from Albuquerque to Cleveland to get to what I thought was the best for me (Cleveland Clinic, Dr. Svensson). I was not disappointed and am doing great today (2-1/2 yrs later).
Wishing you the best!
I’m actually near the Ogden area! My uncle who’s a doctor recommended me a surgeon there. I’m finding it difficult to know what to look for when choosing a surgeon.
 
Mayo Clinic in MN is also very well organized to work with patients from out of state. When I talked with them about planning for surgery, they used the test results from my other hospitals for advance planning. Then the day before my surgery, they did the various tests that they thought needed to be updated. So i actually only had to travel to Mayo 2 days before my surgery.
I’ve considered Mayo Clinic. I think unfortunately I’m stuck in state because my insurance will only cover in state. There is 1 doctor in Vegas that takes my insurance, but the rest are in Utah
 
Good comments Timmay.

A lot of the younger doctors are, unfortunately, being steered toward non-mechanical options here in the USA. I can only guess that the medical device community (Big Pharma) is behind that push

Yes, that is the trend. It's vexing. I would suggest that it is a combination of marketing and some physicians not having a good grasp of statistics. I consulted with two different surgeons prior to my surgery. The question came up as to how long I should expect the relatively new Resilia valve to last. They both told me about the same thing- given my age, I could probably expect about 10 years from a tissue valve. We don't have enough data for the new valve yet, so until we know, we can't suggest that it will last longer. Some forum members in my age group are told about the same thing as I was told. Yet, some members my age, and even younger, come out of their consults and report that their surgeon told them that Resilia will last them 20+ years, 25+ years and we have even seen people report they were told it should last 30+ years. Why are the numbers all over the place when surgeons talk about the same valve for the same age group?

I'm going to go down a little rabbit hole on this one, so apologies. But, physicians are just human beings. There, I said it. That may be controversial, but there it is. Human beings are subject to be influenced by marketing, some more than others. Also, some humans are very good at math and some are very bad at math, and many fall in between these two extremes. Physicians are not an exception to this.

I did not go on to medical school, but during my undergrad at UCLA, I originally intended to do so. My major was medically related and I was on the premed program. It was not required, but recommended that we take a medical statistics class. The classroom was actually located in the UCLA hospital, as over 90% of those taking the class were doctors and nurses. They got continuing education credits for taking the course.

I was stunned at the low level of the course. I would have put the level of difficulty at about 6th or 7th grade, and that may be generous.

I would have expected most to not miss even one question on the first exam, given how basic it was- but the average score was about 60%. One of the problems on the exam was the following:

"A certain surgery has a mortality rate of 5%. If 1,000 patients go through this procedure, what would be the expected mortality."

So, the instructor went over this problem in class, as it was one of the problems which many in the class got incorrect.

Some got it correct, but many did not and the answers ranged from .05 to 500. SMH. With the questions which followed from the class, it was clear that many of my classmates, and yes physicans, had real difficulty understanding conversion of percentage to decimal.

I was a bit shocked and wondered how on Earth these folks managed to pass the MCAT. Well, it turns out you don't need much math to pass the MCAT and become a physician. See link below.

“The MCAT is primarily a conceptual exam, with little actual mathematical computation.”

“You aren’t allowed to use a calculator on the MCAT, so you need to practice doing arithmetic calculations by hand. Fortunately, the amount of calculation you’ll have to do is small.”

Fortunately? Fortunate for who? Not their future patients.

How to Survive MCAT Math Without a Calculator.

When I first saw this comic by Gary Larson, I thought that he must have been a fly on the wall in my medical statistics course.

1706812233249.png



This is not to beat up on physicians. The reality is that most people are not real strong in math. And, physicians are people.
 

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