Selecting a Surgeon and Hospital Recommendations?

[Elgato]

My primary care referred me to a Cardiologist due to a fairly loud murmer.

I actually ended up with a doctor based on availability, not choice. He seems ok but how do you know?

He listened to the heart and immediately ordered a TTE which revealed BAV.

Yesterday we did the TEE and an angiogram is scheduled for next Tue.

He keeps referring to the surgeon as his partner. I have not met him yet.

I am in Tucson, AZ. There are several options for hospitals and multiple surgeons associated with different groups.

The main ones are the University of Arizona Medical Center, Carondelet which ran an actual Heart Hospital here but closed it due to financial problems and Tucson Medical Center.
The Mayo Clinic is in Phoenix which is about 120 miles away.

My primary is with Carondelet and recommended using a Carondelet surgeon/facility but due to availability I ended up with one from a different group. My cardiologist said "check the mortality rates, Carondelet is over four times the national average"

We know a nurse who has worked in multiple facilities. She said that post op nursing care is critical and that the care at University Medical Center is far better than any of the others.
I also think the University of Arizona would be on the forefront of technology.

So, how do you make the right decision. I find it nearly impossible to get actual stats for any specific hospital or surgeon.

I do plan to get a second opinion prior to surgery.

Obviously we all want the best.

Any comments or recommendations will be appreciated.

Thank You

 

[AZ Don]

For a very small fee you can subscribe to Castle Connelly: https://www.castleconnolly.com/index.cfm to look up top Dr's. Last year it was available for free at US News. They still list top hospitals but not Dr's. US News currently lists Mayo Clinic as #1 in Arizona and U of A as #2. Both are high performing for Cardoliology and Heart Surgery. Not sure what impact the closing you mention of the U of A Heart Hospital would have on their level of service. Aside from that I would think you could do well at either. Tucson Medical Center is not ranked.

I highly recommend Mayo Clinic in Phoenix. They have a number of top ranked Dr's which is why I went there for my surgery. My surgeon was Dr. DeValeria and my cardiologist Dr. Shamoun. You should confirm that they take your insurance, they are more limited in what they accept than most.

 

[Gail in Ca]

I have made my choice by picking the surgeon and having the surgery done at the hospital where he performs his surgeries.
Also, I picked the surgeon my cardiologist and former cardiologist and sister's friend, a LA cardiologist recommended.
And, I liked him when I met him. He's very experienced, confident, the go to guy for other doctors, well published, and seems to really like what he does.
Of course, it helped me that he worked at Stanford, one of the best. I have had 3 OHS there, and have ALWAYS felt I would survive before my surgeries.

 

[river-wear]

"Right" decision? :rolleyes2: I'm going through the same thing now, but I've met with one surgeon I found through research, and he also happened to be the guy my cardiologist recommended. I found it's very important to trust the cardiologist and surgeon. (Trust, as in, are you confident in their ability and do they treat you well?) Will they take the time to explain everything and answer every single question you have? Also, it was important for me to have a surgeon who does a LOT of these surgeries. I'm still in the process of getting a second opinion... just to make sure. (I do tend to analyze things to death, but I have the luxury of a little time.)

Your cardiologist already gets points from me for pointing out the mortality rate at the one hospital. You can try some of the free evaluation sites like Health Grades or even Medicare's site. The other consideration is how many AVRs they do each year; more is better. Did they say you already need surgery?

 

[Elgato]

Did they say you already need surgery?[/QUOTE]

Yes, he said I will need surgery but did not say when. He prescribed Metoprolol to help relieve the pressure.
It seems to help. After the Angiogram I have an appointment to discuss and meet the surgeon.

So, I have a Cardiologist who seems ok and he has a preferred surgeon and hospital.(Tucson Medical Center). I am very interested in
the University of Arizona Medical Center due to its reputation and recommendations from the nurse who has worked at several local hospitals.

1. How do you get current ratings and statistics for a specific hospital? Can you just walk into the Surgery Department and ask?

2. Same question about specific doctors. Apparently they all have a mortality rate statistic. How do you get it? I realize that you can just ask them but that
would mean scheduling an appointment with each one. So far I have found front office staff completely clueless. What specific questions would you ask
each potential surgeon?

3. Do I need to see a Cardiologist from the same organization as the prospective surgeon?

4. Mayo is 120 miles away but has an excellent reputation. What issues and problems should I be aware of selecting a Hospital so far away?
I suspect the University of Arizona is rated almost as good but I actually have no proof.

I definitely want to talk to a University Surgeon before proceeding.

Recommendations?

Thank You

 

[Marty]

In some cases its not a bad idea to ask your cardiologist who he would choose to operate on himself or his family. After choosing this surgeon have the operation where he is most comfortable. I am suspicious of "ratings" and "statistics".

 

[Paleowoman]

My (first) cardiologist had a preferred surgeon and he would refer me to no one but him - he told me he always referred his patients to that particular surgeon and that "everyone knows he's the best". When I asked him about two other surgeons he said they were both no good and he wouldn't let them touch a member of his family. I did not believe him as one of those surgeons had been recommended to me by three other consultants I'm under and another surgeon had done the most operations by far of the type I was going to have (data on the Society of Cardio Thoracic Surgery - don't know if the US equivalent has similar). I therefore got a second opinion from another cardiologist (who I am now under) and went with his recommendation since it tied in with my own research. I felt my first cardiologist only referred to 'his' surgeon as they were pals

I don't think it's an easy thing to choose a surgeon or hospital. Once you've chosen one and got referred see if you click with that surgeon…but bear in mind that not all surgeons are good with people (mine wasn't) - probably one reason why they go into surgery rather than becoming physicians !

 

[Jkm7]

I'm one who firmly believes the support/nursing staff for heart surgery is of high importance. The surgeon works his magic but it is the nurses, the techs, the support staff that take care of us. I was at ease being in Mass General knowing their record of experience and competence. The staffing in CICU and step down heart floor have seen and handled it all. While certainly the choice of surgeon is critical, don't disregard the importance of those who will be giving you the hands on care.

 

[Elgato]

I am now in the process of finding a second opinion, either with the Mayo in Phoenix or the University of Arizona.

1. Do you start the second opinion process by making an appointment with a Cardiologist from the organization or can you go
directly to a surgeon?

2. I will have TTE, TEE and Angiogram results. Is this all the new doctors will need? Do you have them sent or just pick up CD's and take them?

Its extremely confusing and I know you guys are not experts. However I am sure a few of you have already navigated this path.

Any help will be appreciated.

Thanks again for your time.

 

[mcsf]

Elgato,

Like you I had a second opinion. I contacted the surgeon directly. Any and all recent test results were shared electronically via DVD. I had just had a cath procedure to look at a few things. It was easy to share the information. It will require a small amount of paper work to release the information from one doctor to the next.

Like JKm7 said, really look into the after care. The after care staff will be doing all the hard work. Some nursing staffs are great. Others show up for work.

 

[DebbyA]

Hi Elgado,
I recently went through the decision-making process here in Tucson. We talked to medical professionals of all kinds and chose the surgeon whose name consistently was recommended. Send me a private message if you'd like to correspond about or discuss specifics of doctors. (Only my opinion, but I'd be wary of UMC just now--they seem to be in disarray, having suspended two top surgeons, and I'd want an iron-clad guarantee that it hasn't filtered down through the organization.)

 

[AZ Don]

You can just call up Mayo and ask to schedule an appointment with a Cardio-Thoracic surgeon. That's what I did. In Castle Connolly's listing of top Doctors, as of 6 months ago, the following Cardio-Thoracic surgeons from Mayo - Phoenix are on the list:
Dr. Francisco Arabia
Dr. Patrick DeValeria - he was my surgeon
Dr. Louis Lanza - designated as a top Dr.

I think the Dr's are considered to be in the top 10% in their field just to make the list, and a top Dr. is considered to be in the top 1% in their field.

 

[Lynlw]

I am now in the process of finding a second opinion, either with the Mayo in Phoenix or the University of Arizona.

1. Do you start the second opinion process by making an appointment with a Cardiologist from the organization or can you go
directly to a surgeon?

2. I will have TTE, TEE and Angiogram results. Is this all the new doctors will need? Do you have them sent or just pick up CD's and take them?

Its extremely confusing and I know you guys are not experts. However I am sure a few of you have already navigated this path.

Any help will be appreciated.

Thanks again for your time.

IF you most likely need surgery in the near future, I would probably contact the Surgeons. What I do is contact the heart surgery dept, tell them I want a 2nd opinion w/ a certain surgeon, and find out what exactly they need.
Most likely they will want CDs DVDs of the latests test, echo, MRI Cath whatever you already have. and make the appt. IF you do not prefer a certain surgeon, I would ask for which surgeon they reccommend for what ever you are having done. Usually in centers with a few heart surgeons, certain ones do more of 1 type of heart surgery, such as Aorta and aorta valves, Mitral valves, REDOs, Bypasses, transplants etc MOST hospital websites, list their surgeons, and a brief biography. Beside listing where they trained and did residency and Fellowships Usually they list what their interests are and many list all the papers they have written so you can get a good idea of who would be specialist there for different things.

Then you have to contact your Cardiologist or the Medical records dept where you had the testing done and request copies of the test sent to whoever you are getting 2nd opinions from. Most likely you will have to fill out all kinds of papers including HIPPA forms giving them permission to send your records to other Doctors. Every center has its own HIPPA and medical record request forms, but often they are available at the Hospitals website, so you can just print them out and fill them out at home.

I personally have found, if possible, it might be quicker to go in person to request the records and fill out forms, or even if you are really anal like me and both hospitals are close, also ask when they can have everything ready and I will pick them up and take them to the other doctor myself. So I know they will be there in time for the 2nd opinion doctors to carefully go over all the information.

How ever if either center isnt that close, you just have to rely on them to send them. It probably would not hurt to ask how long they think it will take to have everything sent and then follow up w/ where you will be getting a 2nd opinion to make sure they got them. In case you have to find out what is going on.

Don' be surprised if the new doctor wants to run their own tests, especially echos

 

[Elgato]

You can just call up Mayo and ask to schedule an appointment with a Cardio-Thoracic surgeon. That's what I did. In Castle Connolly's listing of top Doctors, as of 6 months ago, the following Cardio-Thoracic surgeons from Mayo - Phoenix are on the list:
Dr. Francisco Arabia
Dr. Patrick DeValeria - he was my surgeon
Dr. Louis Lanza - designated as a top Dr.

I think the Dr's are considered to be in the top 10% in their field just to make the list, and a top Dr. is considered to be in the top 1% in their field.

Do they list any in Tucson? 85748

The search says five but you have to pay.

Is this a respected source?

Thank you so much.

 

[AZ Don]

Do they list any in Tucson? 85748

The search says five but you have to pay.

Is this a respected source?

Thank you so much.

I'm sure they do list Dr's in Tucson, but I only subscribed for a month and saved the list of top Dr's in my area (Phoenix). The subscription only costs a couple dollars a month but I saw no reason to continue it. US News and World Report used to list top Dr's as recently as a year ago. Then when I looked again last summer US News had dropped the top Dr list, but it was their website that pointed me to Castle Connelly. I think they used to provide the top Dr data that US News and World Report used to show so I think it is a good source. As I understand it they rank Dr's based on other Dr's input, so popularity may play a role but I know, or know of several Dr's on the list that have a reputation that indicates to me that they deserve to be on the list.