OMG! Why does it take so long to see an orthopedic surgeon?

[Starda01]

I have got to the point where I need a hip replacement and am contacting surgeons to consult about it. But everyone I contact gives me an appointment for 2 or 3 months from now. I’m having a lot of pain from my hip right now and the thought of dragging things out just depresses me. I’m taking Celebrex and have also taken Tramadol, I have acetomedaphin w/codeine for nighttime pain, a TENS unit, and a standbye bottle of wine to deal with it. Some days I can hardly walk, let alone ride. When I ride I have a time dismounting and I am probably hurting my poor horse’s back because of it.

What did you do to deal with the pain and keep riding or active before you got your surgery?

[independentlyawesome]

Do you have a physician who can advocate for you? Having a colleague ask a surgeon to squeeze someone else in the schedule tends to be more effective than the patient just asking.

A great chiro has extended the life of my mom’s hip replacement.

[LauraKY]

If you don’t already have an ortho, it can be tough. This is the reason to have a great internist though…they can pull strings.

[Smiles]

First question is have you been evaluated by an orthopedic doctor? If not one isn’t just going to schedule you for surgery. You need to get set up for a new patient eval and go from there. No insurance company is going to approve you for surgery unless you have a treating doctor and a confirm diagnosis first.

[Simkie]

Short answer to your question: because orthopods are generally in the OR most of the week. I think mine saw patients in the office only one or two days. It’s tough to get in with that schedule

Absolutely have your primary doc advocate for you if you can, but you’re really probably going to have to wait for anyone really good.

[GallopHer]

While you’re at it, go ahead and schedule appts with 2 or 3 different doctors. If you suspect you need a replacement you should plan to get a few opinions.

I had a right THR last summer. Best move I’ve ever made.

Best of luck.

[red_mares]

[QUOTE=Simkie;7658978]

Absolutely have your primary doc advocate for you if you can, but you’re really probably going to have to wait for anyone really good.[/QUOTE]

I was completely shocked when I first saw my current OS. I got an appointment the next week!:eek: It was also November. Last year he took 3 weeks off over the summer. PITA.

The first OS was booked out a month.

Short answer why - doctors like to vacation over the summer like anyone else, and there’s a lot of people in FL who need a hip replacement.

[GotGait]

Pretty much any surgical specialist, in my experience, takes forever to see. I’ve had to wait 3 months for some of them.

[ottbee]

I feel like that is true for all surgeons. I had a non-cancerous tumor in my ear that, left unattended, could have destroyed the thin layer between ear and brain and given me meningitis, and which was eating my ear bones to destroy my hearing. Not cancer, but still very serious.

2-3 months to just MEET the surgeon, then surgery actually scheduled for 6 months later. During which entire time I was in excruciating pain due to infection caused by the tumor, despite aggressive treatment. Was a bad year.

(Luckily I did get my hearing back and did not get meningitis.)

[mickeydoodle]

Gosh- did you all ever think that maybe we are just as busy as we can possibly be? Maybe we are seeing 30-40 patients a day 2-3 days a week and operating the other 2-3? And taking ER call? And trying to take care of a house, family- maybe ride a horse( at least I do, an Orthopaedic sub-specialist) once or twice a week? I had my own hip replacement a few years ago an struggled through full work weeks before and after, horse did not get ridden for months. And getting older all the time? Not to mention the lower reimbursements every year. What do you think we get paid for a hip replacement? In my state I can do a very complex 4.5 hour surgery, revision, and Medicare pays me $1300.00. ( that is the surgeon’s fee, nothing to do with implant costs which go to the implant company, nor the hospital fees). This includes three months of seeing a patient after surgery at no further charge. All private insurance companies pay based on the local Medicare rates, most average about 120% of Medicare, so they would pay about $1600.00 for the same procedure.

i love what I do, and am fairly good at it. It really distresses me to see complaints like this- people thinking I/we are sitting on my/our ass/es doing nothing instead of seeing suffering patients.

The vast majority of us in Orthopaedics are working as hard as we can to take good care of people and improve their lives!

[Coanteen]

Haha, I thought you were a Canuck - here the wait is, well, longer than that. Some people were waiting a year or more, although the situation for hips and knees has improved somewhat. We’re aiming for 6 months.

But if you can still ride? That’s pretty good tbh. And yeah, docs take vacations too, so there are fewer docs covering for more patients over the summer.

[Starda01]

I get it, I’m just gonna have to make do. Doesn’t mean I’m happy about :no:. I had knee surgery 10 years ago and I didn’t have to wait that long, so it’s a sort of sticker shock to me.

Mickeydoodle - I meant no disrespect to the doctors, I know you work very long, hard hours. So I guess I’m naive about this whole thing, because to get my daughter in for a stress fracture this spring, was pretty quick.

Yes, I can still get on my horse but it’s getting harder. However, since he’s come up with a sticky stifle and is on stall rest and hand walking, well we’re both hobbling around. I feel like I’m in the middle of a lameness epidemic. Hand walking with a bad hip isn’t very comfortable.:no:

I do have one appointment for September and the other doctor that was recommended isn’t available til November. I’m beginning to think I won’t have surgery until next year. Unfortunately my GP just left the practice and now I need to find another. In the meantime I’m also trying to figure out how to rehab my poor horse.

Thank all of you for putting some perspective on things.

[PeteyPie]

Make an appointment with your regular doctor, or best of all, an Internist, like LauraKY says. I am so impressed with Internal medicine doctors which I have needed in several places I have lived. They diagnose and are really good at it, and then they refer you to the specialist if you need one, and they get you in quickly. My doctors have been remarkably and refreshingly well-educated, well-read, and well-informed and they are smart, smart, smart. Maybe I have been lucky, but my experiences have given me the impression that Internal Medicine doctors are smarter than most.

Since you had surgery a few years ago you may remember this: shortly before surgery, you will need a physical by your regular MD or IM doctor to test your general health, do lung Xrays, test blood pressure, etc. to clear you for surgery. They can’t sedate you if you have a cold or lung problem, for example, and untreated high blood pressure needs to be resolved before you are put under. So those ducks need to be lined up. One friend had to scramble with this because surgery was scheduled right away and her regular doctor was on vacation, and of course, she couldn’t see just any doctor because of insurance. It all worked out but was a little stressful.

[Starda01]

Wow, PeteyPie, thanks for the heads up! I was just reading thru the thread on knee replacement in this forum and the site Bonesmart.com was mentioned. That seems to be a good site for info and support.

[mickeydoodle]

Fractures are different- they get added on to the already over full day because they are broke! They are urgent, so we suck it up an add them on. So are infections. But unfortunately for you, it is hard to over book a chronic pain problem when the day is already crazy. On my longest days, Monday and Wednesday, I don’t get done with my day’s charts (stupid electronic medical record has made life so much worse) until 10-11pm. The last patient gets seen about 5pm. So to overbook a new hip pain appointment, which can take 30+ minutes as we go through a thorough exam, discuss the various treatment options, make a plan- it’s hard. Moreover, in FL there are really crazy strict insurance rules about what has to be tried before surgery will be approved. It is a testing ground for the rest of the country. Don’t be surprised if you have to jump through some hoops like 2-3 medicines, therapy, injection, etc before the Ortho is allowed to schedule surgery- insurance rules everything.

also in FL (I don’t practice there but a new doc in my group just left there) don’t be surprised if you see the fellow (an orthopedic doc doing advanced training) or the PA for several visits until you have jumped through the hoops. Joint replacement is super-regulated in FL

[Coanteen]

[QUOTE=mickeydoodle;7660702]
Fractures are different- they get added on to the already over full day because they are broke! [/QUOTE]

Sweet sweet fractures are how I make my moonlighting $$$ (OR assist overnight and weekends).

[red_mares]

[QUOTE=mickeydoodle;7660702]
Moreover, in FL there are really crazy strict insurance rules about what has to be tried before surgery will be approved. It is a testing ground for the rest of the country. Don’t be surprised if you have to jump through some hoops like 2-3 medicines, therapy, injection, etc before the Ortho is allowed to schedule surgery- insurance rules everything.

also in FL (I don’t practice there but a new doc in my group just left there) don’t be surprised if you see the fellow (an orthopedic doc doing advanced training) or the PA for several visits until you have jumped through the hoops. Joint replacement is super-regulated in FL[/QUOTE]

On the positive side, maybe one of these will work for you and you won’t need surgery.

[TWH_Girl]

I wonder if it’s your location, or that the surgeon you are seeing is in-demand (not really a bad quality to have in a surgeon). I live in a small town area so I can get into my guy within a week or two. He’s also a DO and he’s newer so still establishing patient base.

Interesting about FL being highly regulated for joint replacements. I wonder why? Seems to happen just fine in other states without all that. My mom had two hips replaced. Not too bad of a recovery either!

[mickeydoodle]

[QUOTE=TWH Girl;7661552]
I wonder if it’s your location, or that the surgeon you are seeing is in-demand (not really a bad quality to have in a surgeon). I live in a small town area so I can get into my guy within a week or two. He’s also a DO and he’s newer so still establishing patient base.

Interesting about FL being highly regulated for joint replacements. I wonder why? Seems to happen just fine in other states without all that. My mom had two hips replaced. Not too bad of a recovery either![/QUOTE]

FL is a test center for the rest of the country because of the large older population. Everyone should protest the model being tested in FL because it is so restrictive. Protests should go to CmS- Center for Medicare Services. It will become the national standard unless voters protest

[wateryglen]

Just because YOU want it now doesn’t mean it’s gonna go that way! It’s not a medical emergency. Like mickeydoodle said. This happens a lot…people are told they need a joint replacement and they wait & wait then when it gets bad enough; then it’s an emergency to them. But not to the system…sorry. When a doctor says you need a surgery; why did you delay? You clearly have been struggling with the pain & debilitation for some time now…so blame yourself…not the doctors!
I understand the wait & see strategy; I’m living it but when I get it done it will be because I chose it and if there’s delays; it’s on me. And yes some specialists in some areas arre hard to get into see. Plus it depends on MD availability. Have you tried an area where there are more available? And summertime is BIG time busy in ortho offices due to outside activities/injuries & such. Makes sense.
Good luck with getting this dealt with.