How do you decide on the right doctor?

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R

retiredmls

Active member
Joined
May 1, 2010
Messages
38
Location
Central New Jersey
I have been to 2 different surgeons and can't decide which one to go to for my AVR. Other than moderate-severe regurgitaion, I have no other issues. My doctor recommended Leonard Girardi @ NYP/Weill Cornell. Liked him and he told me he does about 350 valve surgeries / year. He spent about 1/2 hour @ the consult. However - the logistics of getting to the hospital by train & cab and/or subway are maddening & expensive. Cost for my husband to stay @ hospital hotel for 2 nights while in ICU - $450+ . Would have to hire a car to drive me home to central NJ on discharge day. Back again in 2 weeks for follow-up. He does do minimally invasive, but only the mini-sternotomy. Haven't been able to get definitive answer as to whether or not he is in my insurance network (although do have 2 coverages)
On the other hand, a friend of a friend had AVR down in Florida by a Dr. Michael Rosenbloom. He is now head of cardiothoracic surgery @ Cooper Univ. Hosp in Camden, NJ.(much smaller than NY) He cleared all of his post-ops so he could spend as much time as I needed to talk/ask questions. He is an hour and a half away by car from my home & in my insurance network. He has done about 200 AVRs and does minimally invasive via right anterior chest incision. He does follow-up 5-6 weeks post-op because he said he found that after only 2 weeks he was simply having 15 min. social calls w/ patients.
My cardiologist is away at a convention & can't talk to her until next week.
Sorry this is so long - but how do I make this important decision?
 
Choosing your surgeon includes choosing the hospital and support staff. You want very experienced, competent, well trained CICU nurses, techs, and staff. You will get that at Weil Cornell. Will your smaller local hospital offer that? Perhaps they have a top notch staff but you need to research that IMO

Also....... this surgeon cleared his post op visits to spend the time with you. I wonder how those post op patients felt? They probably were eager for those appointments to be assured of their progress and condition. They most likely had lots of questions they needed answered. Remember, one day you will be one of those post op patients.

I probably did not phrase this very well and hope you take it in the vein I intended but something to think about.
I wouldn't want my appointment cancelled for anything short of a ''real'' emergency; not a pre-surgery consult. I want my doctor available to me as scheduled.
 
350/year vs 200 lifetime is a huge difference. Volume speaks "volumes." I realize it's easy for me to say don't nickel and dime yourself since I'm not the one paying, but I would do your best not to let travel annoyances make the decision for you--small annoyances in the scheme of things are just that. This is not a knee replacement and you have to live with this decision for a long time.
 
That's a good question, and there are pros and cons to both. It might help to put it on paper, or a big piece of cardboard, to really see the pros and cons of each and put them in order of importance. That's helped me before with decisions.

I felt I was really lucky. Before I knew I needed surgery, I knew who I wanted to do it and that was who my cardiologist referred me to. If it were my decision to make, I would choose the minimally invasive between the ribs approach. That's what I had and what I wanted. I really don't know why the mini sternotomy is even called minimally invasive, since the sternum is still cut; it's just a smaller wound.

Give it a bit of time and mull it over. At least you don't have to make a quick decision. Hope all works out well for you!
 
I went against my cardiologist recommendation of a local surgeion who kept saying "how complicated" my surgery would be. So I made the effort to travel to a more experienced surgeon. While the 7 round trip airline tickets from SEA to SFO and 3 months of renting a car and place for my wife and her mom weren't cheap by any means I really do believe I wouldn't have survived having it at the recommended surgeon/hospital. I'm gald I made the effort to go to the bigger hospital/more expierienced surgeion.

Good luck with your decision.
 
I have made this decision twice. First I decided to go with the local hospital and surgeon. This may have all worked out fine, but at my pre-op cath it was decided that my pressures really were not that bad and surgery could wait.

When I developed symptoms six months later, I decided to get checked 5 hours away at the Cleveland Clinic. Like those who answered above, it was the comfort of the rest of the "team" that is involved in surgery that helped me pick a national leader this time. It cost more, but I have never regretted that decision.

I think it is fine to put down all of the pros and cons to make sure you are aware of what factors go in to your decision. Then go with your gut and never look back. Good luck!
 
retiredmls said:
I have been to 2 different surgeons and can't decide which one to go to for my AVR. Other than moderate-severe regurgitaion, I have no other issues. My doctor recommended Leonard Girardi @ NYP/Weill Cornell. Liked him and he told me he does about 350 valve surgeries / year. He spent about 1/2 hour @ the consult. However - the logistics of getting to the hospital by train & cab and/or subway are maddening & expensive. Cost for my husband to stay @ hospital hotel for 2 nights while in ICU - $450+ . Would have to hire a car to drive me home to central NJ on discharge day. Back again in 2 weeks for follow-up. He does do minimally invasive, but only the mini-sternotomy. Haven't been able to get definitive answer as to whether or not he is in my insurance network (although do have 2 coverages)
On the other hand, a friend of a friend had AVR down in Florida by a Dr. Michael Rosenbloom. He is now head of cardiothoracic surgery @ Cooper Univ. Hosp in Camden, NJ.(much smaller than NY) He cleared all of his post-ops so he could spend as much time as I needed to talk/ask questions. He is an hour and a half away by car from my home & in my insurance network. He has done about 200 AVRs and does minimally invasive via right anterior chest incision. He does follow-up 5-6 weeks post-op because he said he found that after only 2 weeks he was simply having 15 min. social calls w/ patients.
My cardiologist is away at a convention & can't talk to her until next week.
Sorry this is so long - but how do I make this important decision?
Click to expand...
It's not an easy decision to make, is it?

Do you need the surgery right away? Can you wait to speak with your cardio? You might also be able to start a new thread here and ask members from Central Jersey who they went to and who they liked and why; experience from a stranger shouldn't sway you but it might give you some ideas.

Our situation might have been a bit less common but it wasn't easy either. I needed a new cardio also. My husband and I asked around a lot. We met with three surgeons.

We struggled with some travel issues also, though only about a three hour drive. But follow-ups and a need for a brief post-op readmittance weren't easy, because we had that distance issue.

Surgical experience matters. Especially successful surgical experience.

Regarding hotel expense, our hospital had a reduced-rate with a nearby hotel. The hospital also had private rooms and my husband used a cot and was able to sleep in the room with me after the first few nights I was in ICU. It was a comfort to me to have him nearby.

Hope this is helpful. Best wishes :)
 
We don't use Cooper, but I wanted to say they are a pretty big Hospital, not a normal "local" hospital that many people think of. For Min invasive, I'm pretty sure Cooper was part of the trials for the DaVinci.
 
I think someone else mentioned this, but have you checked with the hospital to see if they have deals where family members can stay at nearby hotels for reduced rates. My wife stayed at a first-class hospital just a mile away for five nights at a greatly reduced rate. Many also have shuttle service back and forth to the hospital.
 
Superbob said:
I think someone else mentioned this, but have you checked with the hospital to see if they have deals where family members can stay at nearby hotels for reduced rates. My wife stayed at a first-class hospital just a mile away for five nights at a greatly reduced rate. Many also have shuttle service back and forth to the hospital.
Click to expand...

For her sake, I hope you mean your wife stayed at a first-class hotel. :)
 
Surgeon Choices

Surgeon Choices

I was fortunate enough to really feel positive chemestry with the surgeon my cardiologist recommended. My wife and I both walked away from our first meeting with the surgeon with a high level of confidence for a positive outcome. I think it's important to feel that positive chemestry.

There's definately much to be said for working with a surgeon who has lots of experience. Somewhere along the line, I have to wonder how surgeons get experience doing valve replacements if everyone who needs the surgery opts for the ones who do 300+ valve replacements a year. I suspect there are some gifted, young surgeons who have lots of talent, but have less experience. This said, would I climb on the table knowing I would be the surgeon's first valve replacement candidate...I'm not sure I'd be up for that.

Tough choice...good luck with your decision.

-Philip
 
The $225/ night IS the reduced rate for the hotel that is on the hospital's campus. Although I look for deals when I go in for pleasure, it is next to impossible to get a hotel room in NY for less than $200/night.
 
Lynlw said:
We don't use Cooper, but I wanted to say they are a pretty big Hospital, not a normal "local" hospital that many people think of. For Min invasive, I'm pretty sure Cooper was part of the trials for the DaVinci.
Click to expand...

Yes, Cooper was part of those trials. When I first joined this forum I asked if the DaVinci was used for AVR since I only saw it for mitral valve. Apparently, not yet.
 
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