Which Hand Surgeon is Right For Me?

The field of hand surgery focuses on the non-surgical and surgical treatment of orthopedic conditions and injuries that involve the hand and wrist.
 
The term hand surgeon is often used synonymously with hand doctor and hand specialist. All orthopedic surgeons are trained to take care of simple hand conditions and injuries. As such, they can advertise themselves as hand surgeons or hand doctors. However, orthopedic surgeons who have completed hand surgery fellowship training are true hand specialists. They can 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. Although such a quest is not unreasonable, please keep in mind that the best hand specialist for one patient may not be the best hand specialist for another. It is common for hospitals and clinics to market their physicians as the "best." In his book "Unaccountable," Dr. Marty Makary talks about Dr. Hodad - the most famous surgeon at one of 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 essential tips and questions to ask when trying to find the best hand specialist for you:
​

Ask Your Health Insurance Provider

You should call your health insurance provider and inquire about their referral list. Due to the current health care system changes, the insurers will prefer those hand specialists who employ the insurer-approved standards of care. Your health insurance company may tell you to see Dr. X, although Dr. Y is covered by your insurance but is not on the list of providers they prefer. The hand specialists on the preferred list of providers 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 crucial that you choose the best hand specialist for you rather than let the insurance company choose the best one for them.
 

Ask a Health Provider 

It would be beneficial if you could find someone who works closely with hand specialists and elicit their recommendations. The best question to ask is whom would they want as a hand specialist for their loved ones. The emergency medicine physician will refer you to an orthopedic surgeon within the same hospital system during your emergency room visit. 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. Ask your primary care doctor or an emergency room doctor for the names of several hand specialists in and out of your hospital network. 
 

Hand Surgery Fellowship

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, use the American Society for Surgery of the Hand.
 

Orthopedic Surgeons vs. Plastic Surgeons vs. General Surgeons

Depending on your treatment needs and comfort levels, you will want to inquire about the hand specialist's residency training. After completing hand surgery fellowship training, board-certified orthopedic surgeons, plastic surgeons, and general surgeons can advertise themselves as hand specialists. From the residency training perspective, plastic and general surgeons are not trained to treat broken bones, ligament or tendon tears, or other orthopedic conditions. This is something they learn during the 1-year hand surgery fellowship. However, plastic surgeons are the experts in skin flaps, while general surgeons may be more astute in vascular repairs.
 

Patient Education

Inquire about the hand specialist's willingness to educate his patients about their conditions and non-surgical and surgical treatment options. I 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. Please inquire from the orthopedic doctor about his most common types of surgeries, common procedures, success rates, complication rates, and treatment preferences. 

Personal Websites

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 online presence (personal website, Facebook, Twitter, or Google+) tend to be more accessible and involved in patient care and education. Google is also a great source for patient reviews and patient testimonials.

How Accessible is the Hand Surgeon?

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 MD West ONE paging service. I am also accessible through social media such as Facebook. On rare occasions, when I am out of town, I am still available via phone calls and e-mail, and my partners are 100% available to address any patient concerns in person.
 

Disciplinary History

It is prudent to check the Nebraska Department of Health and Human Services for disciplinary history and disciplinary actions against potential surgeons and health professionals.
 
Hand surgery involves an interdisciplinary approach to care. The treatment success heavily depends on the hand surgeon's technical skill and knowledge, post-surgical hand therapy, occupational therapy, and management of medical issues. For example, I have successfully treated patients with advanced rheumatoid arthritis by advanced reconstructive hand and wrist surgery or finger joint replacement. However, complete patient satisfaction and treatment success directly resulted from patient compliance, physical therapy, and the rheumatologist's medical management of the patient's rheumatoid arthritis.
​
Please, do not hesitate to call my office with any additional questions you may have.