The field of hand surgery focuses on non-surgical and surgical treatment of orthopedic conditions and injuries that involve hand and wrist.
The term hand surgeon is often used synonymously with the terms hand doctor and hand specialist. All orthopedic surgeons are trained to take care of simple hand conditions and injuries. As such, they are able to advertise themselves as hand surgeons or hand doctors. However, orthopedic surgeons who have completed hand surgery fellowship training are the true hand specialists as they are able to take care of the most complex fracture patterns, microsurgical reconstructions of nerves, soft tissues and bone, and reattachment of amputated digits and limbs with the most up-to-date surgical and non-surgical techniques.
When looking for a hand specialist, patients often want to find out who is the best hand specialist in their area. Although such a quest is not an unreasonable one, please keep in mind that the best hand specialist for one patient may not be the best hand specialist for another. It is a common practice for hospitals and clinics to market their physicians as the "best." In his book "Unaccountable", Dr. Marty Makary talks about Dr. Hodad - the most popular surgeon at one of the Boston's hospitals. Unfortunately, "Hodad" was an acronym for "hands of death and destruction." Dr. Hodad had Ivy League credentials and general surgery board certification, but he was such a lousy surgeon that most of his patients often suffered life-threatening complications. Thanks to his warm bedside manner, lack of patient understanding about post-operative complications, and the hospital's lack of transparency, he was one of the most requested surgeons by patients and celebrities.
Here are some basic tips and questions to ask when trying to find the best hand specialist for you:
Tip#1: You want to chose a hand specialist who has completed hand surgery fellowship training and passed an additional board certification in hand surgery. To find out which hand specialists in Omaha have passed this examination, you can use the American Society for Surgery of the Hand link.
Tip#2: Depending on your treatment needs and comfort levels, you will want to inquire about the hand specialist's residency training. Board certified orthopedic surgeons, plastic surgeons and general surgeons are able to advertise themselves as hand specialists after completing hand surgery fellowship training. From the residency training perspective, plastic and general surgeons are not trained to treat broken bones, ligament or tendon tears, or any other orthopedic conditions. This is something they learn during the 1-year hand surgery fellowship. However, plastic surgeons are the experts when it comes to skin flaps, while general surgeons may be more astute in vascular repairs.
Tip#3: You should call your health insurance provider and inquire about their preferred orthopedic hand specialists in Omaha. Due to current health care system changes, the insurers will prefer those hand specialists who employ the insurer-approved standards of care. What this means is that your health insurance company may tell you to see Dr. X although Dr. Y is also covered by your insurance but is not on their list of preferred hand specialists. The preferred hand specialists are the ones who may have a (direct or indirect) financial incentive to limit your treatment or adhere to the insurance mandated standard of care. This is called managed care. For more information, see managed care financial incentives. It is important that you choose the best hand specialist for you rather than let the insurance company choose the one that is the best for them.
Tip #3: Inquire about the hand specialist's willingness to educate his patients about their conditions and non-surgical and surgical treatment options. Personally, I verbally explain the condition and its treatment options, draw pictures if necessary, provide educational pamphlets, and encourage patients to use my website as an additional resource. Turn to Google for help and look for personal websites made by Omaha hand specialists, which can provide you with educational materials and give you a "feeling" for the particular specialist's personality, practice, and level of accessibility. Hand specialists with an active on-line presence (personal website, Facebook, Twitter, or Google+) tend to be more accessible and involved in their patient care and education.
Tip #4: If you want a doctor who truly cares about his patients, ask how accessible he is after hours and on weekends. My patients, for example, have 24-7 access to me via the Nebraska Methodist Hospital paging service. In addition, anyone can e-mail me at firstname.lastname@example.org. Typically, I am able to answer e-mails within 12 hours. I am also accessible through the social medial such as Facebook and Google+. On rare occasions, when I am out of town, I am still available via phone calls and e-mails and if need be, my partner's are 100% available to address any patient concerns in person.
Tip #5: It would be extremely helpful if you could find someone who works closely with the hand specialist and elicit their recommendation. The best question to ask is who would they want as a hand specialist for their loved ones. Ask your primary care doctor or an emergency room doctor for the names of several hand specialists in and out of your hospital network. Hospitals encourage referrals from one doctor to another within the same hospital system. However, when it comes to hand specialists, we are a highly specialized bunch and our numbers tend to be small even in the community as large as the Omaha greater area. The hand specialist at one hospital may not be as helpful to you as the hand specialist at another institution.
Hand surgery involves an interdisciplinary approach to care as the treatment success heavily depends on the hand surgeon's technical skill and knowledge, post-surgical hand therapy, occupational therapy, and the treatment and management of a medical issue, which may have been the underlying cause of a particular hand condition or injury. For example, I have successfully treated patients with advanced rheumatoid arthritis by advanced reconstructive hand and wrist surgery or finger joint replacement. However, the complete patient satisfaction and the treatment success were a direct result of patient compliance, physical therapy, and the rheumatologist's medical management of the patient's rheumatoid arthritis.
Please, do not hesitate to e-mail me with any additional questions you may have.