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How many surgeries does it take to become proficient? Specifically total hip replacement surgery? The surgery that I will undergo will be performed by a surgeon that has 800-1000 surgeries under his belt and has been a MD for 6 years and is not board certified. How does board certification work? Is it important?
How many surgeries does it take to become proficient? Specifically total hip replacement surgery? The surgery that I will undergo will be performed by a surgeon that has 800-1000 surgeries under his belt and has been a MD for 6 years and is not board certified. How does board certification work? Is it important?
First with regards to the number of cases your surgeon has done (and they refer to them as "cases" as opposed to "surgeries"), it's hard to know how many of those 800-1,000 cases were done with your doc as the primary surgeon after they completed their training, versus First Assist (probably as a senior or Chief Resident) or even a much more limited role as a Junior Resident. I don't know how many cases most Ortho's finish training with now, but when my husband finished training almost 15 years ago, he probably had done about 400 total cases, with another 150 or so as a Fellow. So, if he were to tell the very first patient he operated on as a newly minted surgeon starting in his first practice that he's been an MD for 6 years and had over 500 cases under his belt, he would have been telling the truth, if that makes sense. FWIW, my husband has been in practice for 15 years and he does about 350-400 cases a year, which I would describe as a moderate number.
Joint replacements like the THA (total hip arthroplasty) you are going to have are bread and butter to all Orthopedic training programs and all trainees will get broad exposure to them regardless of any additional subspecialty training they receive.
As to the second part of your question, yes, Board certification is important. Any surgeon who is not board certified could be a red flag, however there is often an explanation for it. The way board certification works for Ortho is basically this (unless it has changed significantly the last few years). First, the surgeon must complete and successfully pass the Written Board examination (which is taken right after they complete residency training). Then, they have to practice independently for a few years building up all their case numbers (usually takes about 2 years). This period of time during which they have passed the written boards, but are still gathering the numbers of requisite cases is referred to as Board Eligible (BE). If your surgeon is young and newly out of training, that's the most likely explanation for why they are not yet board certified. Then they submit all their cases to the American Association of Orthopedic Surgeons (AAOS) and the AAOS picks a handful, requires additional data from the surgeon (imaging, outcomes data etc) and the surgeon then flies up to where the Board is located (in the case of AAOS, Chicago) and basically gets grilled by a peer group for hours about each of those cases. Pending doing that successfully, they will become Board certified (BC). And Board Certification has to be maintained (called maintenance of certification) every 10 years. Most other specialties have a similar process.
FWIW, while I probably wouldn't choose a surgeon who just completed their training that month to perform surgery on me, I wouldn't necessarily have reservations about a surgeon with only 2-3 years experience post training performing surgery on me either. A newer surgeon is often much more up to date on technology, equipment, computer and EMR proficiency etc as compared to an older surgeon.
Last edited by Texas Ag 93; 07-16-2023 at 10:07 PM..
First with regards to the number of cases your surgeon has done (and they refer to them as "cases" as opposed to "surgeries"), it's hard to know how many of those 800-1,000 cases were done with your doc as the primary surgeon after they completed their training, versus First Assist (probably as a senior or Chief Resident) or even a much more limited role as a Junior Resident. I don't know how many cases most Ortho's finish training with now, but when my husband finished training almost 15 years ago, he probably had done about 400 total cases, with another 150 or so as a Fellow. So, if he were to tell the very first patient he operated on as a newly minted surgeon starting in his first practice that he's been an MD for 6 years and had over 500 cases under his belt, he would have been telling the truth, if that makes sense. FWIW, my husband has been in practice for 15 years and he does about 350-400 cases a year, which I would describe as a moderate number.
Joint replacements like the THA (total hip arthroplasty) you are going to have are bread and butter to all Orthopedic training programs and all trainees will get broad exposure to them regardless of any additional subspecialty training they receive.
As to the second part of your question, yes, Board certification is important. Any surgeon who is not board certified could be a red flag, however there is often an explanation for it. The way board certification works for Ortho is basically this (unless it has changed significantly the last few years). First, the surgeon must complete and successfully pass the Written Board examination (which is taken right after they complete residency training). Then, they have to practice independently for a few years building up all their case numbers (usually takes about 2 years). This period of time during which they have passed the written boards, but are still gathering the numbers of requisite cases is referred to as Board Eligible (BE). If your surgeon is young and newly out of training, that's the most likely explanation for why they are not yet board certified. Then they submit all their cases to the American Association of Orthopedic Surgeons (AAOS) and the AAOS picks a handful, requires additional data from the surgeon (imaging, outcomes data etc) and the surgeon then flies up to where the Board is located (in the case of AAOS, Chicago) and basically gets grilled by a peer group for hours about each of those cases. Pending doing that successfully, they will become Board certified (BC). And Board Certification has to be maintained (called maintenance of certification) every 10 years. Most other specialties have a similar process.
FWIW, while I probably wouldn't choose a surgeon who just completed their training that month to perform surgery on me, I wouldn't necessarily have reservations about a surgeon with only 2-3 years experience post training performing surgery on me either. A newer surgeon is often much more up to date on technology, equipment, computer and EMR proficiency etc as compared to an older surgeon.
I know that he is young. That’s why im nervous about him. His reviews have all been good. His reviews go out only 7 months though.
I had to go with him to get this done as I’m in terrible pain and the more experienced docs are 3-4 months away for appointments.
I know that he is young. That’s why im nervous about him. His reviews have all been good. His reviews go out only 7 months though.
I had to go with him to get this done as I’m in terrible pain and the more experienced docs are 3-4 months away for appointments.
When you click on that link, look directly under his name. It says "Board Eligible". That's exactly the scenario I described in my post. He's likely less than 2 (or maybe 3 years) out of training, and still gathering cases before he can sit for his Oral boards.
This is cut and paste from his website:
Dr. Davis dedicated many years to his education. He received his Bachelor of Science in Health Science Biology and Bachelor of Science in Biochemistry from Tennessee Technological University in Cookeville, TN. After receiving his Bachelor’s, he went to the University of Alabama School of Medicine in Birmingham, AL, where he earned the 2016 UAB Outstanding Medical Student in Surgical Studies Award. He then completed his Orthopaedic residency at Loyola University Medical Center, Maywood, IL, and finally, completed an Adult Reconstruction Fellowship at the Southern Joint Replacement Institute in Nashville, TN.
He went to Med school at UAB. Not super familiar with it, but can say it's a solid, blue collar Southern Academic Medical Center. Looks like he did his residency at Loyola in Chicago area. Don't know much about the Chicago programs outside of the heavy hitters UC, Rush (and to a lesser extent, Northwestern), but from what I recall, Loyola had a decent reputation. Most importantly though, he's Fellowship trained (which I bolded). I'm also not familiar with the group EmergeOrtho, but looks like it has over 200 surgeons in the group. That's a pretty big subspecialty group, which is good. I do know that Duke and OrthoCarolina have historically been the well known facilities in NC.
He's young and getting his feet under him to build up his practice and referral base. That doesn't necessarily mean he's not proficient or good at what he does. Adult Reconstruction/Joints fellowships are hip and knee replacements all day, every day. That's pretty much all they do, so they tend to get very good at it. If you feel good about him, and his reviews and feedback from others are good, then I say, go for it. If you are in such pain and your QOL so adversely impacted, you'll want to get this done asap. Right?
Last edited by Texas Ag 93; 07-17-2023 at 01:15 PM..
When you click on that link, look directly under his name. It says "Board Eligible". That's exactly the scenario I described in my post. He's likely less than 2 (or maybe 3 years) out of training, and still gathering cases before he can sit for his Oral boards.
This is cut and paste from his website:
Dr. Davis dedicated many years to his education. He received his Bachelor of Science in Health Science Biology and Bachelor of Science in Biochemistry from Tennessee Technological University in Cookeville, TN. After receiving his Bachelor’s, he went to the University of Alabama School of Medicine in Birmingham, AL, where he earned the 2016 UAB Outstanding Medical Student in Surgical Studies Award. He then completed his Orthopaedic residency at Loyola University Medical Center, Maywood, IL, and finally, completed an Adult Reconstruction Fellowship at the Southern Joint Replacement Institute in Nashville, TN.
He went to Med school at UAB. Not super familiar with it, but can say it's a solid, blue collar Southern Academic Medical Center. Looks like he did his residency at Loyola in Chicago area. Don't know much about the Chicago programs outside of the heavy hitters UC, Rush (and to a lesser extent, Northwestern), but from what I recall, Loyola had a decent reputation. Most importantly though, he's Fellowship trained (which I bolded). He looks like a typical Ortho bro.
He's young and getting his feet under him to build up his practice and referral base. That doesn't necessarily mean he's not proficient or good at what he does. Adult Reconstruction/Joints fellowships are hip and knee replacements all day, every day. That's pretty much all they do, so they tend to get very good at it. If you feel good about him, and his reviews and feedback from others are good, then I say, go for it. If you are in such pain and your QOL so adversely impacted, you'll want to get this done asap. Right?
I only met him once so I don’t know how I feel about him. His reviews go back only 7 months. I’m seeing him again in a couple of days. What questions should I ask him?
And yes I’m home bound and my quality of life now pretty much sucks.
Don't worry about Google reviews. They are often unreliable. IME, I know a lot of docs are frustrated by them because they sometimes attract only entries from people who have an axe to grind. It's hard to get satisfied patients to provide reviews (even if they say they will) and most docs and practices don't want to harp on it because it seems a little tacky and potentially unethical (if they provide something of value in exchange for a review).
I'm not a clinician, and not qualified to give any clinical advice, so I'll steer clear of pretending to know much about THA success rates, approach (posterior/anterior/modifed etc). Have you looked at the American Academy of Orthopedic Surgeons (AAOS) website for patient resources, FAQ's etc? That might be a good place to start. There's also many message boards and forums. Facebook has some groups for hip replacement for example.
Maybe some things to think about: How thoroughly does he communicate with patients before and after surgery? Does it seem like he listens well? How does he interact with staff? Is he accessible? Return calls quickly (or have his Clinical Assistant do so)? How does he handle pain control? Does the practice have multiple locations that are nearby and easy for you to get to?
It sounds like you are suffering a great deal and ready to move on this based on this and some other comments you've made on posts. If you feel comfortable with him and there are no obvious red flags, then don't overthink it. I'm not saying don't do your research, I'm just saying that medical care and services are something that, unfortunately, consumers often can't judge the quality of (at least clinically anyway) and all surgeons have successes and failures. There are no guarantees. For example, my Dad's partner and my MIL both used the same surgeon to do joint replacements years apart and unbeknownst to each other. My Dad's partner used him for a knee about 15 years ago and had complications a few years later. She does not have a favorable opinion of this guy. My MIL had her hip replaced by him about 5 years ago, and sailed through with flying colors. She thinks he hung the moon.
Thanks so much for this information. I see Dr Davis on July 20th. I’ll see how I feel abut him after that appointment.
Frankly I’m on daily Oxytocin and watching Netflix all day. This after daily exercise and being outside most of the day. My quality of life sucks big time. I need to get this done.
When you click on that link, look directly under his name. It says "Board Eligible". That's exactly the scenario I described in my post. He's likely less than 2 (or maybe 3 years) out of training, and still gathering cases before he can sit for his Oral boards.
This is cut and paste from his website:
Dr. Davis dedicated many years to his education. He received his Bachelor of Science in Health Science Biology and Bachelor of Science in Biochemistry from Tennessee Technological University in Cookeville, TN. After receiving his Bachelor’s, he went to the University of Alabama School of Medicine in Birmingham, AL, where he earned the 2016 UAB Outstanding Medical Student in Surgical Studies Award. He then completed his Orthopaedic residency at Loyola University Medical Center, Maywood, IL, and finally, completed an Adult Reconstruction Fellowship at the Southern Joint Replacement Institute in Nashville, TN.
He went to Med school at UAB. Not super familiar with it, but can say it's a solid, blue collar Southern Academic Medical Center. Looks like he did his residency at Loyola in Chicago area. Don't know much about the Chicago programs outside of the heavy hitters UC, Rush (and to a lesser extent, Northwestern), but from what I recall, Loyola had a decent reputation. Most importantly though, he's Fellowship trained (which I bolded). I'm also not familiar with the group EmergeOrtho, but looks like it has over 200 surgeons in the group. That's a pretty big subspecialty group, which is good. I do know that Duke and OrthoCarolina have historically been the well known facilities in NC.
He's young and getting his feet under him to build up his practice and referral base. That doesn't necessarily mean he's not proficient or good at what he does. Adult Reconstruction/Joints fellowships are hip and knee replacements all day, every day. That's pretty much all they do, so they tend to get very good at it. If you feel good about him, and his reviews and feedback from others are good, then I say, go for it. If you are in such pain and your QOL so adversely impacted, you'll want to get this done asap. Right?
The Southern Joint Replacement Institute in Nashville, TN has terrific reviews! That eases my mind a bit.
You'll be fine. This guy, at least on paper, is no slouch. There will be others in the operating room watching...an assistant, a surgical nurse, a resident, etc. so his approach will be monitored.
Hip replacement is pretty basic stuff. Yes, it is one of the biggest bones in the body, but it is more cutting and beating new hardware in place than anything really fine. Determine if you are having both the ball and the socket done, or just one side. Really doesn't matter, but you would certainly like to know.
Hip doesn't do much in terms of movement. Whereas a shoulder, or even a knee, has to have a lot of motion, a hip is more stable.
Good luck. You are asking the right questions. There must be a Facebook group on Hip Replacements if you feel the need to chat with people who have "been there, done that".
You'll be fine. This guy, at least on paper, is no slouch. There will be others in the operating room watching...an assistant, a surgical nurse, a resident, etc. so his approach will be monitored.
Hip replacement is pretty basic stuff. Yes, it is one of the biggest bones in the body, but it is more cutting and beating new hardware in place than anything really fine. Determine if you are having both the ball and the socket done, or just one side. Really doesn't matter, but you would certainly like to know.
Hip doesn't do much in terms of movement. Whereas a shoulder, or even a knee, has to have a lot of motion, a hip is more stable.
Good luck. You are asking the right questions. There must be a Facebook group on Hip Replacements if you feel the need to chat with people who have "been there, done that".
Thank you brother Bear! And thanks for that tip! I’m recovering from C-PTSD and as a consequence my anxiety really gets ramped up when I need to make difficult decisions, especially when it comes to my body.
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